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A Comment on my Blog that needs promoting

A while back I received a comment on the article Four Reasons Bipolar is Accepted and Borderline Personality Disorder is Not that was apparently re-posted on a forum for people with BPD. It turns out that many of the people with BPD identified with this comment (more than my post actually). So, I thought I’d re-post this comment as a blog post so that people can read it (in a highlighted sort of way):

I do not think that lying and manipulation are part of this diagnosis. If they seem to be present, look either to another PD or to shame and anxiety as the cause, along with a long history of learning to never overtly state what you needed to be okay, or to express how rotten you felt, as the consequences always seemed to be much worse…

Sometimes it seems as if people hate those that are dx BPD precisely because they haven’t quite gone off the deep end for good. It’s bewildering how many professionals seem to resent them for this too.
They may curl up in a fetal position for hours, but then they will struggle out of bed and go on. They smile at us, while their inner world self-destructs. They might seem as alive as anyone, but -in the best of times- they feel dead inside; and as intelligent and gifted as many of them are, they never realize their full potential. But they would rather die than admit this to the outside world.

Who would today be dx’d BPD? Vincent Van Gogh, Kafka, Proust, Nathanial West, Sylvia Plath, Anne Sexton, Janis Joplin, Jim Morrison…

It’s ironic that they are so often seen as “emotional” when what they lack is a full nuanced range of emotions. Inner tension keeps anxiety coiled, emotionally stressful situations release it, and before they have a chance to think through what they feel, they are overwhelmed by fear and anger and despair. They get mired in their negativity. Studies have shown that those with BPD do not get angry more often than anyone else, but they have trouble leaving it behind when they do. And afterwards they drown in remorse, because these reactions are NOT felt to be syntonic. No one seems to pay much attention to this, but all other “personality disorders” are understood to be PD’s because they are syntonic with the personality. This is radically different in BPD.

That right there should raise lots of doubts about what this dx is. Is it part of the affective disorder spectrum? Is a akin to partial seizures in frontal lobe epilepsy? Is it a developmental disorder akin to autism? This is all possible, and perhaps BPD is a dx given to many different people who do not share underlying causes. This should at least stop us from quickly claiming that they CHOSE to feel the way they do. As if they were hell bent on living in hell…

When they do awkwardly, fearfully, try to communicate this pain, when they do reach out for help, they generally do so when their psyche is at it’s most shattered. They will quickly learn that their behavior is not acceptable to anyone. So they’ll go through DBT or through some other behavioral therapy, and sink into so much shame and guilt that lo and behold they will no longer qualify on the DSM for BPD; they will have learned to suffer in silence and to isolate (if they haven’t before – many of those with BPD will never consult a therapist in their lifetime and go through life pretty much invisible), learned to not bother anyone, but the dysthymia, the insomnia, and the dysphoria will still be there, eroding their lives, their aliveness. And as hard as they try, fear will still strike them out of the blue when they least expect it. As hard as they try, they will still plummet down into misery with the least negative emotion. Skinless creatures, they can not tune out human suffering, they can do nothing about the heightened sensitivity that they were born with. Only now no one will know. And so hopefully, thankfully, no one will ever call them “Borderline” again.

 

 

Ask Bon: Why does my loved one with BPD fear judgment so much?

Judgment Hurts those with BPD

A person with BPD fears judgment almost to the point of being allergic to it. She is extremely sensitive to judgment from other people, even if that judgment is merely perceived. Because of the shame (the belief that she is a bad person and deserves to be deemed as such) and the rejection sensitivity, a person with BPD avoids situations in which her actions can be judged by others. When I say “judged” here and “judgment,” what I am referring to is not “using one’s better judgment” in a situation, but rather it is the sense that a person’s actions or the person herself can be judged as “right or wrong” in a given context.

Interestingly, even with a strong fear of judgment of herself and her own behavior and self, she also tends to judge other’s behavior and character harshly. How many times has your loved one with BPD told you that you were doing something “wrong” or that you are a “mean” or “bad” person?

Fear of judgment and emotional reactions to judgment (real or perceived) is a major issue for a person with BPD. Judgment of her actions causes emotional pain and to avoid judgment, she might lie or avoid social situations in which she feels she will be judged. If she is consistently concerned with doing something “the right way” or she feels that you think she “does everything wrong,” it is likely that she suffers from a fear of judgment.

Additionally, there is a stigma associated with being “crazy” when a person has BPD. A person with BPD might feel “not normal” inside and might have felt that way most of her life. However, if the outside world labels as “crazy” or “not normal” or “mentally ill,” it becomes an external validation for what she might already feel. The fact that others “know” about her can make her feel exposed. It is a form of judgment and fear of it that reduces the likelihood that the person will “admit” she has a problem.

Ask Bon: Why does my borderline rage at me?

Rage burns and burns

In the support groups, rage is one of the most talked about aspects of BPD. Why? Because it is one of the most difficult for the Non-BPD to endure. Many people ask themselves, why is this person so angry (with me)? It seems to make no sense. A person with BPD will fly into a rage about seemingly nothing. The smallest thing that is out of place or not done the way that this person expects causes sometimes hours of anger and raging, yelling and screaming and sometimes physical violence. Again, many Nons ask: “what’s up with that?”

Anger and rage are usually secondary emotions to other primary ones. Sensitivity to judgment plays a major role in the triggering of rage. The symptoms and feelings associated with BPD interact and, at times, feed each other. In the case of rage, I believe that it is fed by two other symptoms: shame and sensitivity to judgment (which is also fed by shame).

When someone with BPD feels shameful and when you (as a “Non”) criticize or judge her behavior as “bad” or “negative,” the trigger for rage is pulled within the person with BPD. Why? Because your judgment reflects her shameful feelings and resonates deeply into her core beliefs about herself. She panics that you are “finding out” that she is a bad person. She has to (at all costs) defend her “goodness.” What I have found with my own borderline is that this is the point at which she will rage and introduce the “what about you?” argument. The “what about you?” argument is a way to rage at the Non and release anxiety about the Non finding out about her shameful “badness.” Some people in the support community like to call this “projection” or “denial.” I personally don’t believe it is actually projection or denial (although there are times in which projection is clearly there). It is a form of misdirection to try to take the focus off their inner shame and refocus the discussion on you and your faults.

Nobody is perfect, not even you. When a person with BPD rages against you, you often feel very imperfect – especially if she uses the “what about you?” attack. When someone with BPD uses the “what about you?” technique she is usually deflecting blame and judgment on you. However, you experience the rage as hurtful to your very self. You find that the rage “forces” you to defend yourself against her. That is what the “what about you?” attack/rage does best. That is its intention; it puts you on the defensive and shifts focus away from her and her behavior. As I said, it is form of redirection away from the person with BPD’s shame.

One interesting thing about raging is that once the anger and raging is done, it is usually over. Sometimes the person with BPD will be exhausted after the rage and will just collapse and go to sleep. The same is the case with tired children. Sometimes a tired child will have a temper tantrum (which is a form of rage) and then, once the emotions are released, she will either go to sleep or sit placidly in your arms. The inner agitation has been released and she is done.

Adapted from the FAQ from When Hope is Not Enough

5th Anniversary of ATSTP List and Some Support for Non-BPDs

Today is the 5th anniversary of the Anything to Stop the Pain support list. After over 50,000 messages and 600+ members, it is still going strong. The ATSTP list is offered for free to non-BPDs. In honor of this momentous occasion, I will clip a response from me to a list member. Any personal details have been removed. The only thing blog readers need to know is that this man’s wife has been diagnosed with BPD and is asking him for a divorce. We also have a couple of recovered borderlines on this list and they are a valuable resource (as is noted here):

I believe that there is no right or wrong way to approach human emotions – there’s an effective way and an ineffective way and there are shades of grey in between those “polar” opposites. The effective way gets a positive outcome. That positive outcome is typically the return to baseline of the borderline and the establishment of a modicum of trust with others. One of the most important issues with borderlines seems to be the idea that they believe no one understands them (they feel “strange” – I said “broken” in WHINE, but I think that it was [a recovered borderline on the list] who clarified that it’s more like a “not feeling ‘normal’ and ‘fitting in’ feeling”), they can’t trust anyone with their emotions because many people have invalidated their feelings throughout their life and this leads to “silent desperation” and the inability to communicate effectively how they feel. If, through the use of my tools, you are able to gradually establish an environment in which your wife feels that she can safely express her emotions, which will go a long way toward establishing trust.

Secondly, you posted that you feel as through your feelings do not have a forum for airing and validation. Unfortunately for you, your wife sounds like a typical borderline. She is impulsive, she cuts, she abuses substances – especially painkillers. The divorce talk is probably born of either shame (“I will leave you before you leave me”) or of a feeling that she is being judged and/or disrespected (or not appreciated and accepted for whom she feels that she is). That leads to a certain mind-set that essentially makes her believe that, since no one has ever listened to her feelings before, she must dig in and hold on to her feelings as if she is the only person in the world. That is, “if I don’t fight for myself no one will”. This situation makes it difficult for you to express how you feel because she gets the message (even if it is not true): “YOU MADE me feel this way” because she thoroughly believes that about you. The reason she believes that you (and others, not just you) make her feel like she feels is that she is unable to self-regulate and looks to others to regulate her own emotionally states. When [a recovered borderline on the list] said something about her being more worried about what you think of her, she hit the nail on the head, because a borderline (and possibly for biological reasons) has a great deal of internal chaos and the usual strategy (also possibly biological) is to internalize other’s feelings and opinions about her self. It’s odd, yet I think that this dynamic is the one in which all the talk of not respecting boundaries arises. She feels at some level that you are actually a “part” of her, because she requires external validation. When that external validation turns to judgment, she has to cut you out of her mind. Sadly, she will continue to seek others (particularly men) to self-regulate until she can self-regulate.

As for IAAHF (“It’s all about his/her feelings”), one thing that many people read into that is that EVERY interpersonal situation is about her feelings and that she will not EVER be able to empathize with yours. This is neither the intent of IAAHF or the case. Borderlines are really empathetic (really no kidding they can be) but only when they are not on fire internally and emotionally. The intent of IAAHF is to EXPLAIN the “crazy” behavior, not to make a blanket statement about the relationship. When asked “why would she cut herself?” (for example) the answer is IAAHF. She’s in pain and the cutting helps alleviate that pain. Or asked “why is she raging at me over nothing?” (which happened to me the other night, presumably out of the blue). The answer is IAAHF.

A Preoccupation with Interpersonal Relationships

This feature is a new one that I have added to my “model” of BPD. I added it because I was attending the International Society for the Study of Personality Disorders (ISSPD) and listened to Dr. John Gunderson present a detailed model of his experience with BPD. The purpose of the presentation was to present a “real world” clinical model of BPD from the viewpoint of someone with many years of experience treating the disorder. One of the features that Dr. Gunderson provided was this “preoccupation with attachments.”

I believe this feature is born of an unstable sense of self. A person with BPD has difficulty “locating herself in the world.”  While two of the other “core” features of BPD are “systems related” (meaning, those features are based on subsystems of the mind – the emotional regulation system, the impulsivity control system), shame and the preoccupation with interpersonal relationships are based more on a person with BPD’s view of herself. While it might seem that interpersonal relationships are outside of self, a more complex picture arises as we look more deeply into the mental configuration of BPD.

A recent study showed that the number one trigger of systems dysregulation (like wildly swinging emotions and impulsive behavior) is interpersonal distress. This interpersonal distress is more important as a trigger of dysregulated behavior than sweeping/major life changes – in fact major life changes, such as changing jobs, getting married, having a child – were ranked last of nine factors that trigger BPD distress. The interpersonal, moment-to-moment perception of the state of an important relationship is the most important trigger. That can be bad news for someone in a close relationship with someone with BPD. The person with BPD will be continuously scanning the interpersonal landscape for threats. Since shame is involved, people with BPD are likely to use others to regulate their internal systems and their self-view. In other words, a person with BPD uses others as a mirror to view their self.

Why is this so? I believe that a person with BPD’s lack of internal regulation causes her to internalize other people and use others to self-regulate. When someone has an inability to locate herself in the world, which very possibly arises from the emotional instability as a child, she seeks to have others locate her for her. She needs others to verify and validate that she’s “ok”. Unfortunately, because few of us are taught the language of emotional regulation, a person with BPD will likely learn that the interpersonal landscape is not safe; it is full of threats to their very self. It’s not an easy situation in which to live. If a person requires external validation and regulation, there develops a sense of a lack of control. Others are unpredictable, don’t understand how it feels and can damage the very core of her being.

People with BPD have described this internal feeling of emptiness and lack of internal controls as feeling “dead inside,” which is in itself, tragic. Extending this feeling to others through this preoccupation with close interpersonal relationships leaves a person with BPD with the feeling that others contribute to this unpleasant internal feeling. In other words, “it’s your fault that I feel this way.”

Many Non-BPD’s ask me why their loved ones with BPD don’t seem to trust them. To me, this aspect of BPD is a significant factor, along with other biological factors.

All of that being said, let’s suffice it to say that interpersonal relationships play a huge role in BPD. Social connections and attachments, including parent/child attachments, are the focus point of a person with BPD’s sense of well being. When these trigger dysregulation and/or ineffective modes of thinking and behavior, a person with BPD is lost in the world, floating free in a threatening sea of feelings, thoughts and behaviors.

One must understand that in order for the interpersonal tools to work properly, they need to be understood and applied in a step-wise fashion. I have often said to my list members that “you can’t boil the ocean” which means that you can’t jump to the end before you walk the path. You can’t do everything all at once. Instead, you have to take one small step at a time in a longer journey. The goal of all of my tools, attitudes, skills and approaches is (in my mind) a compassionate, trusting, respectful and two-way relationship in which both parties feel known, heard, understood and worthy. Achieving that goal is hitting a grand slam so to speak. Yet, I feel that a person must be given the fundamentals and practice those fundamentals before you can hit one out of the park. Emotions which are the first layer to unravel peel back from the onion that is BPD. Understanding emotions in oneself and others is vital to having a two-way relationship with someone with BPD.

BPD, Self-Regulation and Others

Ok, after posting about book sales recently and stuff like that, now it’s time for a much more substantive post about BPD. Today, I plan to talk about self-regulation and a new study that points out an intriguing aspect of BPD. There has been much talk in the BPD research and clinical community about the “core” of BPD. Once it was thought to be a personality disorder or even an extreme form of PTSD.  Dr. Marsha Linehan (the inventor of DBT) talks about dysregulation in a number of systems, the most important of which (in my interpretation) is the emotional regulation system. People with BPD are extremely emotionally sensitive and subject to emotional “cues” or triggers. They seem to have a less tolerant (in the “controls” sense of the word, meaning more highly sensitive) emotional system. They are triggered more easily and the reactions seem to be more intense and longer-lasting. In “When Hope is Not Enough” I compare this feature to a heat-sensing device and say:

The core problem with BPD is poor emotional regulation. That particular problem can cause other symptoms to arise as the person with BPD becomes emotionally dysregulated. This term emotionally dysregulated (or just dysregulated) is used to denote the state in which a person with BPD is overcome with powerful and, at many times, misaligned emotional reactions. Remember that emotions don’t arise on their own; they are based on cues or triggers from the environment and compared by our “emotional immune system” to the meaning of the cue. For a person with BPD, the meaning can be misjudged or, as is more often the case, the sensitivity to emotional cues is greatly heightened.

An example is a heat-sensing system that helps to detect and suppress fires. Sometimes companies will install heat-sensing equipment in addition to smoke detectors so that they can protect assets that need a certain temperature to operate (e.g. computer equipment which might cease working at a high temperature). The setting at which an alarm goes off might be 80 degrees Fahrenheit. In the case of someone with BPD, the setting (or “tolerance” as it is called in the control community) is naturally set much lower, at say, 50 degrees Fahrenheit. That means that the alarm will be raised much more often and lead to a reaction to the alarm. In other words, people with BPD will experience many, many (what you would consider) false alarms. However, these false alarms seem completely real to them, because their tolerance for emotional triggers is set very low. They are constantly running a fire drill. Unfortunately for you, the BP may drag you along unwillingly and unwittingly for the drill. (Pages 32-33 of WHINE)

As you can see, the position I take in WHINE is that emotional regulation is the “core issue” of BPD. This position is in line with the DBT way of thinking, which is why one of the “modules” of DBT is emotional regulation skills.

The question is today: is emotional regulation at the “core” of BPD? Or does it go deeper than that? Is there a “cause” for emotional regulation? What are the triggers and how does a person with BPD’s internal feelings affect this “systems dysregulation”?

In the American Journal of Psychiatry, Drs. Stanley and Siever recently (January 2010) publish an article entitled “The Interpersonal Dimension of Borderline Personality  Disorder: Toward a Neuropeptide Model “ in which they seem to posit (in my interpretation again, since I am a lay person and not a doctor) that this systems dysregulation actually has another cause instead of being a “core cause’ of the disorder. They begin the article like this:

Borderline personality disorder is a complex disorder associated with substantial morbidity, mortality, and public health costs. Prominent symptoms include suicidal behavior, nonsuicidal self-injury, aggressive outbursts, and emotional reactivity, all of which typically manifest in an interpersonal context. For several years, there has been an ongoing discussion about whether impulsive aggression or affective dysregulation is at the core of the disorder. While these factors are important in borderline personality disorder, it is the exquisite interpersonal sensitivity that frequently triggers both dysregulated affect and impulsive behaviors, which suggests that this sensitivity perhaps rests at the core of the disorder and may in turn drive impulsivity and dysregulated affect.

Shame and BPD

In researching the implications of shame in BPD, I found this research study:

Shame and Implicit Self-Concept in Women With Borderline Personality Disorder

* Nicolas Rüsch, M.D., Klaus Lieb, M.D., Ines Göttler, M.D.,
Christiane Hermann, Ph.D., Elisabeth Schramm, Ph.D., Harald Richter, Ph.D.,
Gitta A. Jacob, Ph.D., Patrick W. Corrigan, Psy.D., and Martin Bohus, M.D. *

*OBJECTIVE: *Shame is considered to be a central emotion in borderline personality disorder and to be related to self-injurious behavior, chronic suicidality, and anger-hostility. However, its level and impact on people with borderline personality disorder are largely unknown. The authors examined levels of self-reported shame, guilt, anxiety, and implicit shame-related self-concept in women with borderline personality disorder and assessed the association of shame with self-esteem, quality of life, and anger-hostility.

*METHOD: *Sixty women with borderline personality disorder completed self-report measures of
shame- and guilt-proneness, state shame, anxiety, depression, self-esteem, quality of life, and clinical symptoms. Comparison groups consisted of 30 women with social phobia and 60 healthy women. Implicit shame-related self-concept (relative to anxiety) was assessed by the Implicit Association Test.

*RESULTS: *Women with borderline personality disorder reported higher levels of shame- and guilt-proneness, state shame, and anxiety than women with social phobia and healthy comparison subjects. The implicit self-concept in women with borderline personality disorder was more shame-prone (relative to anxiety-prone) than in women in the comparison groups. After depression was controlled for, shame-proneness was negatively correlated with self-esteem and quality of life and positively correlated with anger-hostility.

*CONCLUSIONS: *Shame, an emotion that is prominent in women with borderline personality disorder, is associated with the implicit self-concept as well as with poorer quality of life and self-esteem and greater anger-hostility. Psychotherapeutic approaches to borderline personality disorder need to address explicit and implicit aspects of shame.

http://ajp.psychiatryonline.org/cgi/content/abstract/164/3/500

On My Side

Are you and your BP on the same team?

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.

Fear and Shame

Fear and Shame

Fear and Shame

Today, I figured I would discuss fear and shame. Not many people realize the impact that these two emotions have on people’s behavior. I believe that most of the “controlling” behavior in relationships is based on these two emotions.  My daughter is angry at her boyfriend for being controlling. He monitors her and gets upset when she does something that is not what he expects. I believe that his behavior has to do with his fear of losing her to someone else and his shame that he feels deep down that he is not really good enough for her. Shame is particularly corrosive, and it is, of course, a big problem in BPD. Fear has to do with the unexpected and thinking about the future with trepidation. Expecting the worst or, better, fearing the worse, is how many people operate – especially if they are wracked with shame.

The core idea here however, is that these two emotions, which motivate controlling behavior, are not about the person who is being “controlled.” No, these emotions are about the controller. I often say in my group (and in my book) that poor behavior in someone with BPD (or anyone in fact) is “not about you” (the recipient of the behavior) or, after rephrasing it: “it’s all about his/her feelings” One of the misunderstandings of that attitude in some of my readers is that some people read that and think “When is it about MY feelings?” That was never the intention of this approach. In fact, the idea was intended to be a way of elucidating the motivation of the behaviors to which Non-BPs object. You see, in my experience, the behaviors of a person with BPD (or anyone emotional) can be explained as being motivated by poorly regulated emotions. The behaviors serve a function which is to halt the negative and overpowering emotional states. Fear and shame are very painful emotions and any person will do anything to halt them (anything to stop the pain). So, while the behaviors seem to be directed at you (like my daughter’s boyfriends controlling behavior seems to be directed at her), in reality the function of the behaviors is to halt the pain. If the fear and shame were not present, the behaviors would cease to exist. That is why I encourage people to act on the emotions directly, rather than on the behaviors directly. This is possible through the application of emotional skills both within one’s own mind and within the context of the relationship.

Marriage Problems and Authentic Self

marriage-counselingToday I was reading the Psychology Today blog of Dr. Steven Stosny, called the “Anger in the Age of Entitlement” blog. Here is a nice article that married people (BP, Non-BP and others) should read:

Marriage Problems: How Can I be Me When You’re being You?
By Steven Stosny on August 18, 2008 – 3:09pm in Anger in the Age of Entitlement

Most people get married because they like the way they are with their partners – loving, compassionate, engaging, supportive, sexy, and flexible. They get divorced because they don’t like the way they are with their partners – resentful, turned off, frustrated, rigid, or bored, all of which they blame on their relationship.

In the course of this death march, many go into marriage therapy to find better ways to manipulate their partners into, at best, doing what they want or, at worst, becoming who they want. The self-defeating flaw in this strategy, apart from the fact that it hardly ever works, is cognitive dissonance — the discomfort generated by holding contradictory cognitions.

In marriage, cognitive dissonance is the difference between how you would like to be and how you are. For instance, “I am loving, compassionate, supportive, sexy, etc., yet I am not these things with you.”

This aspect of cognitive dissonance isn’t bad; it can act as a motivation to be true to your deepest values, by making you behave in more loving and compassionate ways. Unfortunately, most people who divorce or go to marriage therapy choose to resolve their cognitive dissonance with something like this:

“Since I am unable to be my loving and compassionate self with you, you must be too selfish, insensitive, withholding, demanding, emotional, rigid, sick, or defective in some way.”

This ill-fated resolution of cognitive dissonance only makes you both feel like victims and sends you searching online or in self-help aisles for a checklist that validates your suffering and a diagnosis that nails your partner.

Cognitive dissonance can undermine marriage (and marriage therapy) in sneaky ways, even when you are successful at getting what you want, namely, change in the other person. If you do get what you want by changing your partner, your self-concept is reduced to:

“I am loving, compassionate, supportive, etc., as long as you do what I want.”

Do you really want this on your tombstone:

“As long as I got what I wanted, I was great to the people I love,” ?????

The irony is that the last thing you need is an externally regulated self concept, i.e., one determined not by your own behavior but by what your partner does for you. Externally regulated, your sense of self becomes totally dependent on your partner, not just for consistently doing what you want but for doing it with love and joy in his/her heart, since resentful submission is far from satisfying. Externally regulated, self-concept needs more and more validation, if not submission, from the partner to stay afloat. This sends satisfaction on a downward spiral as it necessarily destabilizes both the sense of self and the relationship.

Successful marriage is not about getting your partner to do what you want; it’s about being who you are, i.e., behaving according to your deepest values. For most people, this means being loving and compassionate to the people they love.

Happily, you have the best chance of getting your partner to do what you want by being who you are.

Consider the effects of positive reciprocity and negative reactivity. Which of the following is more likely to inspire cooperation?

1. Approaching your spouse as your authentic, loving and compassionate self
2. Approaching your spouse with entitlement and demands (even if couched in the rehearsed language of “behavior requests”)?

Marriage (and marriage therapy) run into a brick wall of cognitive dissonance when they focus on “getting your needs met,” or “getting the love you want.” They are more likely to have lasting success with focus on each of you being the partner you most want to be.