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You know all, there’s something weird about the sales of “When Hope is Not Enough” – I have tracked sales each day (because I can and because it matters to me) and I have noticed something decidedly weird about those… I sold an average of 2 books a day for the first 12 days of June… and then nothing. Why? I have no idea. I don’t advertise the book much. Yet, if you look at the sales of other competing books – those seem to be going along fine. I have no idea what happened. I mean from 20,000 in sales rank to 200,000+. Strange. Look you all, this book is helpful. It has helped hundreds of people – almost a thousand at this point. I don’t make a living being Bon… yet if you drink the kool-aid – it works! I could quote the readers (and I will soon) but I’m tired. Hey it’s almost 1 AM. I just don’t get how I sell 2 books a day and then nothing in 2 days. Weird.
 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.
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.
Update to my previous post about “When Hope is Not Enough” being number 10 on the Lulu-published Amazon sales list. Well, today WHINE hit #5 on the June list. Again, thanks all. I appreciate it. It appears that the book is becoming more popular. I have happy about getting the message out!
 When Hope is Not Enough Hits #5 on Lulu/Amazon List 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.
Apparently, “When Hope is Not Enough” is available for the iPad now. I don’t have one, so I can’t share it or whatever you do with those things. But this week, I got an unexpected boon from Lulu regarding my sales from last month. I sold 13 copies of my book in the iPad format.
Today, my book When Hope is Not Enough cracked the top ten (at #10) on the Amazon sales list for books published through Lulu. Thanks all! I “hope” the book will help each of you.
 When Hope is Not Enough reaches number 10 for May sales Lulu books
 Books for a Non-BPD I decided today to re-do my recommended reading list and use my Amazon store in its place. I felt it was getting kind of hard to maintain, and a bit stale. The new version has more good books on Borderline Personality Disorder, emotional skills and other such things. I arraigned it in categories now. Those categories are:
- Best Non-BPD books (self-help and informational books)
- Research on BPD (current and past research – mainly for therapists)
- Emotional Skills books (I particularly like Ekman’s books)
- Other books (Miscellaneous books on training, mindfulness and decision-making)
- And, my new favorite:
- ATSTP List Member Books (recommended by members of the ATSTP email list)
Check them out and enjoy. One feature I really like of Amazon’s is the provision of similar items and lists by other members of Amazon. While I might not recommend their suggestions, sometimes they are still quite helpful.
 Where are you on the tree? When I talk to Nons, either in person or virtually, I find that they have the biggest problems with the behaviors of their loved ones with BPD. In When Hope is Not Enough, I outline a way to work on behavior modification and help the person with BPD change problem behaviors. The tool of reinforcement is number eight out of a tool of eleven tools. It rests on the foundation built through the application of other tools (mostly emotional ones) and attitudes presented in When Hope is Not Enough. In other words, behavior modification through reinforcement, which is usually called “shaping,” is not possible without first understanding, implementing and mastering the tools and attitudes presented before the eighth tool. That said, today I’d like to talk about another problem with using behavior modification techniques with someone with BPD: that problem is the scale at which many nons try to make the change. I have come up with a brief “model” that can help you figure out if you are operating at the right scale. This model uses a tree as a metaphor. The largest scale is presented first, with me gradually winnowing it down to the smallest and most effective scale.
In the sky:
- She is selfish.
- She is lazy.
- She’s a chicken.
- He’s a bully.
- She’s a liar.
- He’s too rigid.
- He’s closed-minded.
- She’s so dramatic.
- She’s immature.
- He always has to be right.
In the leaves:
- Her up-bringing made her that way, so she can never change.
- He doesn’t care about anyone.
- She needs to be more rational and not freak out all the time.
- She was spoiled by her dad.
- She was abused.
- He thinks he’s better than everyone else.
- She doesn’t care about my feelings.
In the branches:
- He lacks empathy.
- She doesn’t know how to communicate.
- He’s got to listen more.
- She screws up all the time.
- He doesn’t spend enough time with the kids.
- He rages at me for nothing.
- She needs to learn to cope.
On the trunk:
- He needs to come home earlier.
- She needs to learn how to do it herself.
- He should be on time more.
- She has to stop making so many commitments.
- He has to be more polite to my friends.
- She has to stop finishing things halfway through.
- He has to be less critical of my family.
On the ground:
- I’d like for him to spend Saturday afternoons with the kids.
- I’d like for her to pay the phone bill.
- I’d like for her to send a thank you note to my mother.
- I’d like for him to say hello to my friend when she comes over.
- I’d like for her to work on the kitchen project we agreed to do.
- I’d like for him to arrive home at 6PM on Tuesdays.
What I have found is that many nons come to support forums with a basket full of problems at various scales along the tree. Some are character traits, some are psychological explanations, some are wide behavior patterns, etc. The problem with this approach is that a non can’t solve (or work with the BPD to solve) all the problems at once. Secondly, large, general problems are not solvable in a support forum. One has to solve, through behavior modification (and the use of the other tools in When Hope is Not Enough) specific problems with specific outcomes. Once you are at ground level, you can actually get something worked out, because if the specific positive behavior is observed, you can reinforce that specific behavior. That is the “one small step at a time” approach to behavioral change. It is the only one that actually works.
All, because of the change in Google Checkout’s commission formula – I have to raise the price of my eBooks by $1.00. The cost of the eBook for When Hope is Not Enough: a how-to guide for living with and loving someone with Borderline Personality Disorder is now $7.00 (USD). The cost of But I Love You: a primer for understanding a loved one with Borderline Personality Disorder has risen to $5.00 (USD). The upside of this change is that now that Google Checkout has implemented digital-goods delivery, you can get your eBook moments after you order it!
Here are the new Google Checkout buttons for these two eBooks:
When Hope is Not Enough: a how-to guide for living with and loving someone with Borderline Personality Disorder ($7.00 USD)
But I Love You: a primer for understanding a loved one with Borderline Personality Disorder ($5.00 USD)
 What is your goal? I have recently made a realization about the other Non-BP writers and myself. I realized that our goals are completely different. When reading other books about being a loved one of a person with Borderline Personality Disorder (mainly those written by lay people, as opposed to professionals), I have found that essentially we fall into three categories. These categories are:
Those that are chiefly concerned with stopping the emotional abuse doled out by the person with BPD. This category is the largest of the three. Most books written about being a loved one of someone with BPD fall into this category. These books include: “Tears and Healing”, “Stop Walking on Eggshells”, “The Essential Family Guide”, “The Siren’s Song”, “Loving and Loathing”, “One Way Ticket to Kansas” and others. Typically these are written by ex-spouses as guides to getting out of emotionally abusive situations and protecting oneself from emotional abuse. Most of these have an emphasis on boundaries or limits, tough love and abusive dynamics (such as the victim-rescuer-perpetrator triangle or Stockholm Syndrome). If your goal is to stop the abuse directed at you from your loved one with BPD, I believe reading these books can help you do that; however, I don’t think you should expect to keep the relationship and, if you do keep the relationship, I wouldn’t expect that it would grow to be a close, loving relationship. The tools and techniques in these books will not help you build such a relationship with someone with BPD.
Those that are written by people who have recovered from BPD and wish to promote a better understanding of the disorder. These books include those by Rachel Reiland, A.J. Mahari, Tami Green and others. I find these books to be helpful for the intended purpose. It certainly helps a loved one understand what it feels like to have the disorder. However, I also find that many of these books are short on what a loved one can do to build a loving relationship with a person with BPD. These books are inspirational for people who want to recover from BPD, but I don’t feel they provide the complete picture when it comes to the loved ones.
Those that promote an effective, skillful path to building a loving relationship with someone with BPD. As far as I can tell, I am the only “lay person” in this category. There are some professional books, such as “New Hope for BPD,” which attempt to achieve this goal, but no other first-hand experience books that I have found other than my two books, “When Hope is Not Enough” and “But I Love You”. If your goal is staying with your loved one with BPD and building a loving, compassionate relationship, I think I am your only choice.
I implore you to consider your goals and choose your path accordingly.
The other day I received a nice comment from a woman with BPD. She told me that she was planning on revealing to her long time significant other that she has been diagnosed with Borderline Personality Disorder (BPD). She said that she was planning on giving him 2 books – “When Hope is Not Enough” (my book) and “I Hate You Don’t Leave Me”. She was hoping that her SO will better understand her by reading these. Personally, I was flattered. To have my book used in that way makes me quite gratified.
Here is a quote from the end of her message to me:
Another thing that I really appreciated about your book is that it’s both empathetic for the person with BPD and for those around him (sorry, not buying your “her” pronoun  ). I found it incredibly non-judgemental for a book about BPD. Generally, books on the subject either gloss over the distress that relatives of BPs may feel (because it’s not the subject) or are incredibly insensitive in their descriptions of BPs. I can’t begin to tell you how much I appreciated that your book was not describing me as some cold-blooded monster revealing in torturing others. I was, however, intrigued by the part in which you talk about poor self-esteem in BPs as a pathological trait (I don’t have your book with me right now, so I can’t quote you precisely on this one). There’s one thing about BPs that can’t be denied, they’re poor partner choices. So when I tell my bf something along the lines that he could have done better than me, I think it’s pretty much a realistic perception. I mean – if only a small part of what is written about BPs is true (and in this regard, your book is the cream of the crop of non-judgementalness) it would still be realistic from BPs to think of themselves as poor partners, if not as poor human beings.
So, that was about it. Congratulations for the good job.
As you can see by her kind words, here is someone with BPD feeling that “When Hope is Not Enough” is empathetic and non-judgmental which was exactly my intention when writing the book. If you have BPD and want a book to help explain to your loved ones… “When Hope is Not Enough” is an excellent choice. Although it is short, it is dense and packed with information. I’d have to say “But I Love You” which is my shorter guide for loved ones of people with BPD is probably not quite as empathetic and non-judgmental as “When Hope is Not Enough”.
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