Anything to Stop the Pain – For Non-Borderlines and Loved Ones of People with BPD « Anything to Stop the Pain

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

A primer on Emotional Dysregulation and its role in Borderline Personality Disorder

Emotional Dysregulation and BPD

What is important for Non-BPDs to realize about BPD-like conditions and disorders is that they have a core component in common, which is called emotional dysregulation. A disturbance to one’s emotional regulation system can exhibit itself in a number of ways, and the behavior of the borderline (a person with BPD) and the feelings of the Non-BPD are generally confused and misunderstood unless seen through a lens of emotional dysregulation. Emotional dysregulation is not a “grand excuse” to remove responsibility from a disordered person. No, it’s a “grand explanation” to explain the reflexive (yet often confusing) behavior of a disordered person. It’s a way of understanding the motivations (reflexive behavior to stop powerful emotions – which is what IAAHF means) and the intent (to get out of pain).

I put the words emotional dysregulation in bold because that concept is vital for the Non-BPD to understand what BPD is all about. What upsets the Non-BPDs most about the disorder is the behaviors associated with BPD – raging, lying, substance abuse, unfaithfulness, dangerous risk-taking and others. The Non-BPDs feel put-upon and under siege, yet what motivates the behaviors of the borderline is that they are awash with negative emotional states. They have a reduced capacity to regulate their emotions. Continue reading A primer on Emotional Dysregulation and its role in Borderline Personality Disorder →

It's the emotions stupid

In “When Hope is Not Enough” I quote renown Buddhist monk Thich Nhat Hanh about anger. Here is the quote:

Anger is an unpleasant feeling. It is like a blazing flame that burns up our self-control and causes us to say and do things that we regret later. When someone is angry, we can see clearly that he or she is abiding in hell. Anger and hatred are the materials from which hell is made. A mind without anger is cool, fresh and sane. The absence of anger is the basis of real happiness, the basis of love and compassion.

…

When we are angry, we are not usually inclined to return to ourselves. We want to think about the person who is making us angry, to think about his hateful aspects – his rudeness, dishonesty, cruelty, maliciousness, and so on. The more we think about him, listen to him, or look at him, the more our anger flares. His dishonesty and hatefulness may be real, imaginary, or exaggerated, but, in fact, the root of the problem is the anger itself, and we have to come back and look first of all inside ourselves. It is best if we do not listen to or look at the person who is the cause of our anger. Like a fireman, we have to pour water on the blaze first and not waste time looking for the one who set the house on fire..

The thing is that many people, when overcome with emotions, have a tendency to focus on the situation and causes of the anger (who set the fire) vs. the anger itself. This reason is why I try to refocus non-borderlines on the emotions, not the “offense.” People typically defend against the accusations, rather than focus on the anger. Many skills can be applied to cool the anger, but defending is not one of them. Defending just fuels the flames.

Putting out the fire of anger

Instead of defending, I encourage non-borderlines to use the I-AM-MAD communication skill. It’s been a while since I elaborated on that skill, so here it is in a nutshell:

I-AM-MAD

1. Identify the emotions.

It’s best to do this with “feeling” words, like “look”, “see”, or “sound”, rather than “know” or “understand”.

Examples: “I see that you are frustrated.”

“You sound aggravated.”

“You look really upset.”

2. Ask a validating question. Immediately – combine with step 1 to be most effective.

This encourages them to share their feelings about whatever triggered them. Do not use “what’s wrong?” If you use “what’s wrong?” they will hear “what’s wrong with YOU?” Also, don’t assume you did anything wrong. Remember, IAAHF (It’s All About His/Her Feelings).

Examples: “What happened?” (most effective because it is open-ended, requires more than yes/no answer)

“Did something go wrong at work [school] today?”

“Want to talk about it?”

3. Make a validating statement about their emotion.

Validate the feelings expressed in step 2. This helps reinforce that it is natural and valid to feel what they are feeling in the situation. Again, remember IAAHF. Don’t defend against blaming or projecting. And don’t apologize at this point, even if you are guilty. (Apologies for things you are actually guilty of can come later… after they have returned to their emotional baseline.)

Examples: “Wow, it must have made you feel awful to have done poorly on that test.”

“Yes, it is frustrating when it seems that someone is taking advantage of you.”

“Yeah, that’s really disappointing.”

4. Make a normalizing statement about their emotion.

By relating the situation as common to all people or “normal” for them, this helps alleviate their stress about feeling judged or unaccepted.

Examples: “I think anyone would feel angry if they had to do that”

“I would feel the same way if that happened to me.”

“I can see why you feel that way.”

5. Analyze the consequences of their behavior.

By examining the consequences of both negative and positive behavior with the person, you help them to separate their emotional reaction from their behavior. The behavior may need to be changed, but the emotions are natural and should not be punished for.

Examples: “When you don’t ask questions about something that confuses you, I don’t realize that you are struggling, so I can’t help you. When you do ask questions though, I can either give you the information you need to solve the problem yourself or we can work together to figure out the best solution to the problem.

“When you yell at me, I feel disrespected and become upset too. However, when you speak calmly to me, I know you have respect for me, so I am able to listen to you better.”

“When you refuse to talk to me, I don’t know what else to do except give you space. When something is bothering you, it’s best to be open and honest with me so I know what’s going on and don’t make the wrong assumptions about what you need.

6. Don’t solve the problem for them.

Solving one’s own problems helps to build self-confidence. Empower the person by getting them to come up with a solution themselves. When given the opportunity in a non-judgmental setting, most people will find that they can come up with solutions to their problems. You can guide them through this process by asking helpful questions to ascertain what they need or want.

Examples: “How would you like to handle this?”

“What would help you make a better choice next time?”

“Is there anything I can do to help?”

(Note: Sometimes you have to go back and forth to help them find the most effective solution. They may say, “I don’t know” or “I don’t care.” This can be tough. Go back to step one to deal with any additional emotions that become apparent.)

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.

Oppositional Defiant Disorder

Here’s an article about ODD and Conduct Disorder (CD) in children and the correlation to adulthood personality disorders:

Borderline Personality Disorder is called this because patients have many traits from different psychiatric disorders. They have very unstable moods, like bipolar disorder. They often have strange experiences, like people with schizophrenia. Their relationships with others are usually quite unstable. They often don’t have much of a sense of who they really are or where they are going. They often cut themselves. Most of the people with this problem are female. If you have ODD/CD and are female, you have approximately a 15% chance of getting this.

There is also info about Antisocial Personality Disorders. My question is: are these really separate disorders or does emotional dysregulation play a part in all of them? If someone is emotionally volatile it seems to me that they will act out in different ways depending on the emotion they feel most often – anger, sadness or guilt/shame. So, all these different “”disorders”" – ODD, CD, ADD, BPD, APD and others – are they really the same disorder (emotional dysregulation) exhibiting itself in different forms?http://www.klis.com/chandler/pamphlet/oddcd/oddcdpamphlet.htm

An Example of an Angry Non

I found this review on Amazon as a review for the book “”Understanding the Borderline Mother.”" This excerpt says a lot about people’s understanding of borderlines:

Perhaps it is true that the borderline personality is a real disorder in various ways, but I know for a fact that there are borderlines who can control their negative behaviours when they really want to, and that is the most frightening thing of all, that a grown adult can still act so immaturely and continue to destroy other people willfully. I think that someone needs to write a book about this too. Also take in mind that some people who were once classified as “”borderlines”" often improve with age. For this reason, I do think that it’s possible for borderlines to change somewhat, if they really want to.

So, what do we have here?

It is not a real disorder (perhaps).
Borderlines can control their negative behaviors (when they really want to).
A grown adult can act so immaturely?
A person can destroy other people willfully?
They can change (if they really want to)

Hmmm… I guess she feels that borderlines don’t really want to change. They enjoy what they do. Do you feel this way about your borderline?http://www.amazon.com/gp/product/customer-reviews/0765703319/102-3120581-1484128?customer-reviews.start=33

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