Best of,  DBT

A Response with DBT Skills

Below is a response I gave to a member with a girlfriend with maldapative BPD responses:

The purpose is really about HER and not you though. She thinks that
she is not lovable and is a bad person and is shameful inside. So when
you tell her or show her that she is not unlovable she feels a little
better. The big problem in this dynamic is the middle steps and the
assumption that she can only get validation from the outside. She
needs to learn a new way to solicit what she needs without using FOG.
She just knows no other way. A good way to do this is to have her use
DEAR MAN. Here is a link to the DEAR MAN skill:

http://www.dbtselfhelp.com/html/ie_handout_8.html

You will notice that it says: “Describe the situation when necessary –
sometimes it isn’t stick to the facts and no judgmental statements”

Clearly your girlfriend is NOT doing that. You might want to look into
the GIVE and FAST skills yourself:

http://www.dbtselfhelp.com/html/ie_handout_9.html
Look at “Be GENTLE” it says:

“People tend to respond to gentleness more than they do to harshness.
Avoid attacks, threats, and judgmental statements.
No attacks. This one is pretty clear. People won’t like you if you
threaten them, attack them or express much anger directly.
No threats. Don’t make statements like “I’ll kill myself if you….”
Tolerate a no to requests. Stay in the discussion even if it gets
painful, then exit gracefully.
No judging statements. No name calling, shoulds or implied put downs
in voice or manner. No guilt trips. ”

Clearly your girlfriend is not doing this either.

Here are the FAST skills:

http://www.dbtselfhelp.com/html/ie_handout_10.html

Read them, because I think your “giving in” feelings can be lessened
by using these. You usually use the GIVE and FAST skills together.

The assumption part is that YOU are required to make HER feel better.
In the long run, this is never lasting because you could always go
away, make another decision and go against her. That is the dynamic of
fear of abdonment IMO – it is that you will ultimately figure out that
she is a bad person (like she feels about herself) and leave her to
her on devices. All of the things that your girlfriend does boils down
to this pattern. She feels bad about herself, she feels ultimately
unlovable, she feels that the world is hostile and she feels that one
day she will be exposed for the bad person she is. That is why she
does the sex stuff, rages at you, uses FOG, etc. Her tactics are
extremely disordered but, up until now, they are effective for her (at
least for a short time). She is not getting to the root of her issues
though. SHE is the only one who can make herself feel better, not you
or anything else. Unfortunately, untreated she will continue along her
pattern, because she hasn’t addressed the core shame issues.

In the case of DBT, they work on behavior (healthy tactics) that,
after repetition, become conditioned. It could be said they don’t work
on the “root” either – they can’t “fix” her. What they can do is
replace “unskillful” tactics (FOG, cutting, threating suicide, etc.)
with “skillful” tactics (also know as “skillful means” from Buddhism).
The tactics they supply are: Mindfulness, Emotional Regulation,
Distress Tolerance and Interpersonal Effectiveness (of which DEAR MAN
is a skill). Anytime you reinforce an unskillful tactic, you make it
stronger. If you ignore it, it will subside and it is best and
quickest to subside if there is another skillful tactic (that you
reinforce) waiting in the wings.

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