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 Tough Love and BPD Tough Love is not an effective approach with children and teenagers with Borderline Personality Disorder. Although some therapists and self-help authors recommend tough love as what should be done with BPD, it is ultimately detrimental to the borderline and to your relationship with the borderline. The problem comes in regarding the nature of the disorder. While behavioral therapies can work, those based on reinforcement and shaping, those therapies usually include acceptance strategies and non-judgmental approaches. The nature of BPD is that the individual with the disorder is in deep emotional pain because of the dysregulation of the emotional system. They are exquisitely sensitive to emotional experiences and many of these experiences are physical in nature, especially with children. There is intense physical pain and social rejection (to which borderlines are also intensely aware) causes more pain. The borderline will then seek to end the pain in any way they can, including substance abuse, casual sex, thrill-seeking and other dangerous methods. While these methods will stop the pain temporarily, the pain always comes back.
OK, now back to why tough love doesn’t work. A person with borderline personality disorder wants more than anything to communicate his/her pain with those with whom he/she has an attachment relationship. Understand that BPD is not just a case of the person “behaving badly”. The behavior has a function and generally that function is to either stop the pain or to communicate the pain. If you try to deal with behavior with tough love (rules, contracts, boundaries, punishments, etc.), the person with BPD will feel more rejected, more abandoned and unable to communicate the pain. This causes MORE pain and requires more pain-quelling behavior. It causes more of what made you start using tough love to begin with.
A little while ago, I was speaking with someone about a friend of my daughter’s. This girl probably has BPD. Her behavior was totally off the charts – drugs, turning tricks, running away, cutting herself, suicide attempts, etc. When the person I was speaking with expressed sympathy for the girl’s mother, I responded like this: “I think what happened with [girl’s name] was that she was in a lot of pain and didn’t know why. All she really wanted was for her mother to see her pain. All she ever wanted was for her mother to understand her and her pain. But her mother only saw bad behavior and tried to deal with that. So, the girl tried anything and everything to stop her pain.”
The word compassion actually means “to suffer alongside” (or co-suffering). If you’re a parent of a person with BPD, are you seeing and understanding their pain? Or are you fed-up with their “bad behavior”? Developing non-reactive compassion is the answer, not tough love. Tough love sends a message that the borderline can’t communicate their pain. Are you co-suffering? Or are you punishing the borderline for doing anything to stop the pain?
An article “clarifying” the latest Courtney Love custody decision…
Courtney Love in wake of losing custody of Frances Bean: ‘terrible influences, pure evil’
By Vicki Hyman/The Star-Ledger
December 15, 2009, 10:29AM
 Courtney and Frances Bean Courtney Love has left a string of only occasionally coherent messages on her Facebook page in the wake of a Los Angeles court decision to give temporary custody of Frances Bean Cobain to the girl’s paternal grandmother: “cruelty to children and people too young to understand that under that rock isnt gold its only,.,,,,, utah on steroids” and “terrible influences, pure evil. and a poor baby caught inside a trap”.
That clears things up.
Love’s lawyer tells People that Frances Bean, Love’s daughter with dead rock icon Kurt Cobain, wanted to live with her grandmother, and the judge’s decision should not be taken as confirmation that Love has had a drug relapse.
“Courtney’s been clean for years and is perfectly fine,” Keith A. Fink says. “Frances is 17 and a strong-willed child, and this is a decision she made on her own. No matter what, Courtney loves her daughter more than anything in the world.”
Frances Bean has reportedly always been close with her grandmother, who had custody during a particularly messy period (and that’s saying something) of Love’s life in 2003 and 2004.
 Are you and your BP on the same team? I often hear people with BPD/ERD say that they feel that their loved ones are “not on my side” or that the loved ones are “supposed to be on my side.” This phrase stuck out at me when I read the story about the suicide of Megan Meier (the “MySpace suicide” case), because, although I have no insight into Megan’s mental health, clearly when she was insulted and rejected on MySpace, and she was emotionally dysregulated. She came to her mother, and after her mother admonished her for the use of foul language on MySpace, Megan cried and said, “You’re my mom. You’re supposed to be on my side!” ( This according to her mother’s reports).
When someone is highly emotional, they need to know that they have an advocate and that someone is on “their side.” I often ask my consulting clients (especially partners of people with emotional regulation issues) if they feel that their partner and they are “on the same team.” Many times the answer is no. Why does someone have a desire to have someone on their side, even when the “sides” are not desired, intended or even clearly delineated? The answer in my mind comes down to shame and rejection sensitivity.
If a person has shame (or even low self-worth, which is similar), then the person is likely to have a high level of rejection sensitivity. Being rejected by others is painful, especially for emotional people. Having an advocate of their “side” of the issue, which is essentially answering, “I am on your side no matter what the situation,” is tantamount in these highly emotional, social interactions that involve rejection. One can be “on their side” emotionally without condoning whatever behavior that one doesn’t agree with.
There are teaching moments and there are times that one doesn’t teach. If you try and teach, punish or impart values during a period of emotional dysregulation, the relationship will be damaged and nothing effective will be accomplished. Instead, emotional validation and support can be used to cool the bonfire. Once it is cool, then a teaching moment can present itself.
One of the things I have noticed about Dialectical Behavior Therapy Family Skills versus Mentalization Based Skills is that they operate at a different link on the behavioral chain. In “When Hope is Not Enough” I have a section called “the BPD Dynamic.” What this dynamic outlines is a behavioral chain. That chain goes like this:
Event -> Interpretation -> Emotional/Physical Feelings -> Action Impulses -> Expression and Behavior
DBT-FST seems to me to operate at the Action Impulses to Expression and Behavior link, while validating the Emotional/Physical Feelings link. Don’t get me wrong, the DBT-FST skills are extremely powerful in communicating with someone with BPD. Yet, the change that is requested is at the end of the chain. I have heard that Marsha Linehan is quoted as saying something like, “Just because you feel like a crazy person, doesn’t mean you have to behave like one.” The point here is that DBT is a behavioral therapy and by modifying behavior, that works backwards toward regulating emotion and tolerating distress. In other words, DBT trains you to behave differently based on your feelings. When you gradually learn that your new behavior is more effective than the previous behavior, you break the conditioned chain between Action Impulses and Expression and Behavior. That is the essence of the DBT skill “Opposite Action.” An interesting side note is that by practicing Opposite Action (that is, doing the exact opposite of what your feelings implore you to do – such as engaging when you feel sad, rather than hiding under the covers all day), you actually feel better, because the action does work backward. Dr. Paul Ekman found that configuring one’s face to mimic a certain feeling actually causes that feeling to be experienced. That is the theory behind DBT’s “Half Smile” skill. Ultimately though, by working at that link in the chain, the person still feels the emotion, yet he or she just behaves differently than the emotion originally informed him/her to behave.
MBT on the other hand takes on the on the problem at the Interpretation link. By asking questions and being open to alternative interpretations, the person with BPD is more likely to have a broader view of other people’s behavior and the events in life. DBT never asks about the intent or motivation of the other person and just takes the interpretation as a given in a person with BPD. If a person with BPD says something happens and that something means X, then in DBT it means X. There is very little questioning of the validity of the interpretation X. In MBT, however, the interpretation X can be questioned and alternative interpretations (such as Y or Z) can be examined. The nice thing about this is that when the person with BPD is faced with a similar situation, he/she is less likely to jump to conclusion X and might consider Y or Z.
An example of the differences in the two approaches is as follows:
My daughter comes home from school after being teased by a boy on the playground. My daughter ends up throwing a thermos at the boy’s head.
With DBT, I would validate her anger and ask her how she could behave more effectively the next time this teasing occurs. So next time she will behave more effectively and not throw the thermos.
With MBT, I would validate her feelings and begin to probe with curious and straight-forward questions as to the intent of the boy. Perhaps he actually likes my daughter and that is why he is teasing. Perhaps he is showing off to his friends. If this approach is taken, my daughter is more likely to consider the boy’s motivation for the teasing. If she understands the motivation, she can actually never get angry and risk throwing the thermos.
All of that being said, I believe these skills have to be learned as a “ladder” to effectiveness. You can’t start at point E without going through points A-D. DBT-FST provide the foundation for more advanced skills, like those in MBT.
I haven’t written anything about either Nadya Suleman or Kate Gosselin in my blog, because I really don’t know that much about either of them. However, recently I have been watching each of them a bit and trying to figure out what the heck is up with them. Each has a multitude of children, conceived by in-vitro. Each seems to desire public approval/affection. I am not suggesting either of them has Borderline personality Disorder (BPD), because I don’t know enough about either to suggest that that condition (of which I write about in this blog) is even suspected in either. I have seen others suggest a variety of conditions for each of them including BPD (and NPD), but I just don’t know.
The reason I am posting this message though is because both of them seem to have a craving for affection, attachment and love. It appears to me that each had all these children such that they could be unconditionally loved by as many people as possible. I wonder what happened in their childhood (or if anything happened) that would drive this strong desire to have as many children as they have had.
 Not too long ago I wrote an article on why tough love is not the answer for BPD. I still believe that ONLY tough love is not the answer; however, I have come to reconsider tough love and BPD.One of the reasons was that the TIME article said that DBT is a combination of emotional validation and tough love.
One of my list members has moved from the techniques that I provide in “When Hope is Not Enough” – which is basically a non-judgmental attitude plus validation and normalization – to a combination of those techniques plus “tough love.” What is tough love? In my opinion, tough love is the application of PERSONAL boundaries on a relationship. These personal boundaries need to be understood. Often, people don’t understand personal boundaries. Even popular books about BPD for Non-BPs (such as SWOE) get this concept wrong. In fact, even books that are ABOUT boundaries get this concept wrong. The other day I posted a link to a video of a part of the film “The Basketball Diaries” in which Jim Carroll’s mother (Jim Carroll is played by Leonardo DiCaprio BTW and the film is based on the book by Jim Carroll and is true) denies her son money for drugs (he is a heroin addict). She enforces her own boundary (I will not give my son money to buy drugs). She does not enforce a “rule” which is the way that someone tries to control the behavior of another person. Rules and boundaries differ significantly. With a rule, you try and control another person’s behavior – such as telling a child “you have to go to bed at 8:30 PM.” That is a rule, not a boundary, because it has to be enforced. Rules have to be enforced, boundaries do not (except on yourself).
Back to tough love… how does one use tough love with BPD? Well, first of all I have to say you can’t START with tough love, because first emotional trust has to be established. If you start with tough love and use ONLY tough love, that is a recipe for disaster with someone with BPD. The problem is that tough love hurts too much for them. They feel “different” and “broken” and tough love reinforces these feelings. However, tough love can be used once the trust is established. Tough love is something you can use FOR YOU to establish your own boundaries with someone with BPD. But you have to make sure that it’s your boundaries that are being applied and not rules for another person’s behavior.
 When Hope is Not EnoughGet the Non-BPD book that has helped hundreds! If you have the disorder, give it to you loved ones! It will help.
 Recently, I noticed that one of my list members created kobies.org – which is a site dedicated to kids of Borderline Personality Disorder parents. My own kids represent part of this group. What I found was that his site was sending me about 3 times the traffic I was sending him. So, I wanted to highlight his site: www.kobies.org.
Enjoy! (ok, if you’re a kid of a BP you might not be enjoying, but hopefully it will help).
UPDATE: www.kobies.org seems to not longer be available. I don’t know why as of yet.
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.
After reviewing Mrs. Treasure’s article on BPD and Demonic Possession, I decided to read at least some of her other posts at AssociatedContent.com. I wanted to find out if she had posted more on Borderline Personality Disorder and why she decided to post on the disorder in the first place. I think she must believe that her new husband’s ex-wife has the disorder, because she wrote another article called “10 Ways to Handle a Difficult Ex? Focus on Borderline Personality Disorder” which refers to the person with BPD as “she” throughout. I’m not going to agree or disagree with the content of that article.
I also found an article called “Spiritual Glasses to Understand the Difficult Child” which was described with the question: When you get frustrated with your child, what is the most effective discipline? I was intrigued and decided to read the article.
I have to say, I was surprised by the wisdom in some of her comments. I find it interesting that what she says about children can be applied directly to people with BPD. Consider the following:
If your child is a chronic liar, parents worry and panic. The spiritual glasses allow you to see a very insecure child with poor self concept or image. Are your expectations of him too high? Why does he feel worthless? Is he bullied around by friends or older siblings?
I get more searches on this blog for “lying,” “liars,” “chronic liars,” etc. than about anything else. (Actually to be honest the most searches I get are about “celebrities with BPD” or some variant of that, but lying-related searches come in a close second.) I’d like to take her words and apply them to BPD and replace the words “spiritual glasses” with “emotional glasses.” I think if you look at a chronic liar, which many people with BPD are, you will find that one motivation for lying is a poor self image, feeling worthless or insecurity. These concepts are interrelated and spring from shame. People with BPD do have a poor self-image. Even though many nons report that their loved one with BPD is selfish or narcissistic, in reality people with BPD actually hate themselves. This feeling arises from shame as well, but the shame also arises from emotional invalidation. Mrs. Treasures doesn’t really provide a prescription for dealing with a liar, other than not to label (judge) the child as a “difficult child” right away and try to understand them and set proper expectations. The same can be said of a non’s relationship with a BP. Judging their behavior as “difficult” right away or setting expectations too high can invalidate the BP’s emotional responses. This sets up an “invalidating environment” for the child’s emotions and the effects of an invalidating environment are summarized by Dr. Marsha Linehan:
[The] effect of an invalidating environment, especially when basic emotions such as fear, anger, and sadness are invalidated, is that a person in such an environment does not learn when to trust her own emotional responses as valid reflections of individual and situational events. Thus, she is unable to validate and trust herself… If communication of negative emotions is punished, as it often is in invalidating environment, then a response of shame follows experiencing the intense emotion in the first place and expressing it publicly in the second.[i]
If a person is unable to trust herself, she can not validate herself and a “response of shame follows” emotional experiences. That is one pathway to BPD. If you punish a child for feeling inadequate, for example, if the child is lying to you because he wants to make himself feel better about himself, then you are invalidating his emotional responses.
Mrs. Treasures also say this about temper tantrums:
For your younger children showing tantrums and hitting other siblings, the spiritual glasses permit you to see a child struggling to deal with his immature emotions. The child’s frustration is his inability to communicate his feelings and needs to his siblings.
Again, if we substitute “emotional glasses” for “spiritual glasses” and “BP” for “child,” I believe she is accurately describing the state of someone with BPD. People with BPD are emotionally immature. It’s not their fault; it’s just that they were not raised in an emotionally supportive environment. They feel that by feeling emotions intensely, they are wrong and should be punished. Again, the shame comes into play. They do have an “inability to communicate [their] feelings.” Because of the invalidating environment, the BP becomes unable to trust her own emotions and becomes frustrated and angry. THAT is what fuels rage more than anything.
OK, now what do you do to counter-act an invalidating environment (with both children and BPs)? You learn to validate their emotional responses. I have quite a few examples of validation techniques on this site and if you follow this link, you can read about validation.
[i] Linehan, Marsha, Cognitive-Behavioral Treatment of Borderline Personality Disorder, pg 72
I wanted to start re-posting on my blog and the subject of the day is parenting style. I have noticed that there seems to be a conflict between the parenting styles of a person with BPD and that of a non’s spouse. It seems that (maybe because of the invalidation that the BP has experienced) the BP is likely to be harsher with punishments and more likely to invalidate a child’s feelings. I don’t know if this is because the BP sees the emotional volatility reflected in a child’s behavior and is guilty about it or because they never learned to deal with a child’s emotional swings in a way that is validating.
My wife can be very validating and understand at times (even more than me); however, she also takes the “life is hard” and “get over it/suck it up” route with our children at times. I don’t know if you other nons have experienced the same thing, but I see a lot of that in my Google Email Group. If you’d like to discuss this further, you can leave a comment here or, better, request to join the Anything to Stop the Pain Google Email Group by going here:
http://groups.google.com/group/ATSTPGroup
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