Well, Amy Winehouse is in the news again. This type she supposedly threatened suicide. Some times it makes you wonder if she or Pete Doherty will be the first U.K. celeb with (possible) BPD to burn out completely. Here an article from “Now” (who knows how much truth there is to it though):

Amy Winehouse threatens to kill herself

Singer on 24-hour watch by worried friends

Monday, 6 October 2008

Amy Winehouse is said to be on suicide watch after she allegedly threatened to stab herself.

The singer is thought to have been pushed further downhill after her husband Blake Fielder-Civil rejected an offer of parole last month – because he didn’t want to stay with his mum Georgette Civil or wear an electronic tag.

Amy, 25, apparently held a knife to her chest in front of friends.

‘She said she was “caught up in a nightmare”,’ a source tells the Daily Star. ‘Her friends managed to get the knife away from her but are now holding a 24-hour watch on her.

‘Her emotions are exaggerated. She is either high as a kite or, when she hears something she doesn’t like, she is suicidal.’

Blake, 26, is being held at Edmunds Hill Prison after he was found guilty of GBH and attempting to pervert the course of justice. It is now thought that he has accepted another offer of early release.

Bon Dobbs :: Oct.06.2008 :: Celebrities, Suicide, Self-Injury, Borderline Personality Disorder :: 1 Comment »

I have discovered some resources on the web that may help those with BPD (and those nons who are in a relationship with someone with BPD). These resources are:

Mass General Hospital Mood Charting (thanks to Tides…)

DBT Skills Help:

Emotional Regulation Skills… from dbtselfhelp.com … from Borderline Personality From the Inside Out

Mindfulness Skills… from dbtselfhelp.com

Distress Tolerance Skills… from dbtselfhelp.com

Interpersonal Effectiveness Skills… from dbtselfhelp.com

DBT Family Skills Training… from middle-path.org

You can gain access to more DBT resources, to other pertinent files, and to advice from me and other group members by joining the ATSTP (Anything to Stop the Pain) Google Email List.

Bon Dobbs :: Sep.17.2008 :: Resources, DBT-FST, Mindfulness, DBT, Borderline Personality Disorder :: No Comments »

Often in my Internet group people mention that they feel that the difference between people with BPD and Non-BPs is that they have different “value sets.” I disagree with this understanding of BPD. It’s not about values. It’s about emotions. In my opinion, emotions will trump values just about every time, especially in someone who does impulsive things under the influence of strong negative emotions. Emotions operate on a more “primal” level than do values. In WHINE, I quote Peter Steinke’s Healthy Congregations:

When stress and anxiety are high, the R (reptilian) system is exaggerated.  In other words, people become more thoughtless, more instinctive, and more automatic.  The same is true concerning the feeling brain.  Once fueled by limbic-derived feelings, we have less access to the thinking brain.  Both brains have ensured the survival of the individual and the species.  Necessary to survival, feelings have an insistent quality and are hardwired into the nervous system.  With strong arousal, the limbic brain can be driven to continue.  The reactive force can go on for hours.  Highly excited emotional states are like poison ivy - we become all itch.

The point of this quote is to illustrate that emotions operate at a lower level in the brain than do values and even thoughts. The author goes on to say:

One of the functions of the thinking brain is to exercise veto power over the instinctive forces of the two lower brains [Reptilian and Feeling brain].  It sets limits on behavior; it provides self-control.  This is one reason moral codes are stated in the negative - “Thou shalt not . . .”  Nonetheless the lower brains, more automatic and defensive than the thinking brain, have a quicker triggering effect and do not easily defer to the thinking brain.

The phrase “do not easily defer to the thinking brain” is an understatement in my opinion. If someone is overcome with emotions, especially strong, negative emotions which is the likely situation with BPD, the “lower brains” at which the emotions are operating will rarely defer to the thinking brain. Therefore, if a person with BPD acts in a way that goes against his/her values, that is probably the cause.

Bon Dobbs :: Sep.16.2008 :: WHINE Book, Emotions, Borderline Personality Disorder :: No Comments »

Many times I’ve seen Non-BPs mention that couples counseling doesn’t really work for them. One member of an Internet support list I used to be a member of posted a message about his BP “snowing” the couple’s therapist. In fact, just about every message (of hundreds) was about this subject. Clearly, Non-BPs are upset about the dynamics of couple’s counseling and feel that they get “dumped on” by the BP. The Nons end of feeling blamed for everything. When this subject came up in the ATSTP group recently, I turned to a knowledgeable member about this subject. She posted the following message (which I’ve edited slightly because I wanted to remove any reference to others in the group). BTW, I don’t normally repost messages from the group here on my public blog - I only do so when the message contains as much wisdom as this one does, doesn’t contain any identifyable “marks” and is not “personal” in nature.

Well, my experience has been that marital counseling doesn’t really help
much when a BP is involved, because counselors really don’t understand the
dynamics of BPD.  While their goal is to promote better communication
between partners, they tend to focus on resolving the complaints.
Of course, BPs have LOTS of complaints (which
really are not the problem), so nons just end up feeling attacked… even by
the counselor at times.  When counselors do this, it tends to validate the
BPs feeling that their nons really are the problem.  It sometimes even
leaves the non feeling like he/she really is the problem.

I suspect you may want to continue this “counseling” approach, since it is
SOMETHING your BP has agreed to.  If so, my suggestion would be for you to
be as honest as possible with the counselor about YOUR FEELINGS.  Don’t
waste your time (and money) defending against your BPs accusations and don’t
point fingers back.  (This only makes you look bad to the counselor… like
you never let your BP talk or express himself… ha!, I know!)  Simply ASK
for advice on how to communicate better (since that is the goal of the
counselor to get you communicating with one another.)  Try the suggestion a
few times, and if it doesn’t work, then you can come back the following
session and express your disappointment and confusion about why it isn’t
working.  Eventually, after enough times of doing this, your counselor will
(hopefully) recognize that he/she cannot help you and will refer you to
someone more qualified (like a DBT specialist, if your lucky enough to have
one of those in your area.)

My only comment on this statement - which is wonderful IMO - is the idea that the complaints are “not really the problem.” If those complaints are not really the problem, what is? Well, I believe it is that the BP FEELS bad (negative emotions) and judged (so they judge back). I think if someone who DOES understand the dynamics of BPD works with a couple, the therapist can hopefully deal with the real issue: the painful emotions.

Bon Dobbs :: Sep.05.2008 :: Blame, Treatment, Emotions, Borderline Personality Disorder :: No Comments »

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 »