See larger image The Power of Validation: Arming Your Child Against Bullying, Peer Pressure, Addiction, Self-Harm, and Out-of-Control Emotions (Paperback) By (author) Karyn D. Hall, Melissa Cook List Price: $16.95 USD New From: $10.77 In Stock Used from: $11.01 In Stock

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A: This is an excellent question and one that I have grappled with for years. My wife’s behavior before I started down the path to effectiveness was off-the-charts and was affecting my children’s feelings of safety in our household. Numerous times I felt the only solution to protecting my children was to leave my wife and apply for full custody of our children. When my wife was “acting out” and/or in a rage around the children, I would take the kids to the library or to events around town. I worried that they would associate going to the library (a nice quiet place) with my wife’s raging. However, once I understood the reason for her raging, I also understood that there was a more effective solution to my wife’s behavior. The reason my wife was raging was because she had dysregulated emotional states that were painful for her, yet out-of-line with the evidence of the world around her. Still, these emotional states seemed quite real and justified to her. All of her life she has felt that her very being is under threat from those around her. This situation causes fear in her, but the fear quickly turns to rage and no-holds-barred behavior toward others, even those she supposedly loved. In fact, this dangerous and confusing behavior was worse with the immediate family. The reason is that she felt that her emotional states were not understood, not accepted and judged by those with whom she had the most at stake. If your immediate family doesn’t accept you, who will? This judgment and rejection was seen as a prelude to abandonment, rejection and confirmation of her shame. This situation made her frightened, desperate and angry. The anger then translated into rage from which much of the emotional abuse arises.

Behavior is most often conditioned and based on previous beliefs, reactions and conditions. I found that if you, as a loved one of someone with BPD, change the conditions, the behavior will change. If the emotions are accepted and validated, they don’t typically spiral out of control and trigger dangerous abusive behavior. It is not a question of right and wrong, like many people believe it is. It is a question of effective reactions and behavior on your part versus continuing to react ineffectively and, essentially, throwing gasoline on a raging fire. Better to put out the fire with water, which is a soothing elixir. Punishing a person for their feelings becomes translated into more shame since “all feelings all the time” is how they “are”. Rejection confirms that to the borderline that he/she is a bad person, which, in turn, causes more and more rage. Remember, however, that emotions and behavior are not synonymous. You can validate emotions without condoning the resultant behavior.

What about past abusive behavior? When will my borderline take responsibility for that? Should I let that go?

If I’ve learned anything about borderlines in the past five years, it’s that they generally know what they’ve done “wrong” in life, whether or not they will admit it to you. The shame component causes a “deepest, darkest” reflection about who they really are. When a borderline identifies with a particular role in life – such as being a mother – anything that threatens that identity is usually met with fire. Yet, on the flip-side of the defense of their very being, there’s shame, unworthiness and self-flagellation. It is most likely that your borderline will punish herself for the discretions she has committed. Of course, sometimes, the emotion-fueled behavior is not even remembered. It’s sometimes an emotional vomit session to get all the bad feelings out, to purge the nasty sickness of the painful emotions – of course,  those around them can get spewed on. When I said that it might not be remembered some time ago on the ATSTP list, I got a response from a recovered borderline that went “oh, we remember it. We just can’t run to the toilet when it is occurring. And we almost always see the mess that has been made and feel bad about it afterwards.”

My suggestion about “balance” between validation and protecting the children from emotional abuse boils down to the belief that, if the borderline doesn’t let the emotions run away with them, the abusive behavior will (almost) cease entirely. I still get raging from my wife every once in a while – maybe once every 4-6 months. It used to be once every 2-3 days, then it was 2-3 weeks, then once a month and so on. What I changed was the environment for my wife’s emotional expression. I stopped judging her. I validated her when she felt bad. I built a safe, accepting environment for her emotional life. One that she has never experienced before. It was not my “fault” that she felt that way – it was merely how is actually was in her life. I had to accept the reality of the situation and do what I could do to change it.

Several members of the ATSTP list have reported that once they “turned their mind” (and behavior/reactions) toward what I purpose in WHINE, the raging in their borderlines ceased. The Buddha said of dependent origination: “When this exists, that comes to be. With the arising of this, that arises. When this does not exist, that does not come to be. With the cessation of this, that ceases.” My suggestion to each of you is to cause the “ceasing of this” (the non-accepting, judgmental, invalidating environment) to insure that “that ceases” (the abusive, dysregulated behavior).

NOTE “Ask Bon” is a new category within this blog in which Bon answers burning questions about being a non-BPD from his perspective and with the skills an attitudes with which he was able to rebuild his relationship with his borderline wife. The opinions are Bon’s alone.

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When Hope is Not Enough

Overcoming Borderline Personality Disorder: A Family Guide for Healing and Change

Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, & Distress Tolerance (New Harbinger Self-Help Workbook)

I Don't Have to Make Everything All Better

Love Without Hurt: Turn Your Resentful, Angry, or Emotionally Abusive Relationship into a Compassionate, Loving One

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Got BPD? Get This! Great for Everyone Who Needs Validation!, June 16, 2011

I have BPD and I love this book! I no longer walk around feeling like BPD is stamped on my forehead and everything I say or do is a result of my lousy emotional filtering. I can constructively offer suggestions to myself (or others) on how I would rather be treated or spoken to. I can laugh with myself and my partner when something my partner says today about 1 cup of noodles sets off a cascade leading back huge resentment about to 2 tons of dirt and threats of leaving —10 years ago. I am proud of myself as a unique person. I can notice feelings of shame without going down the tubes. My partner bought this book for herself and I love it FOR ME! I don’t feel criticized or judged. I feel validated. I am happy and proud. I’ve been dealing with BPD diagnosis for over 35 years and this book is so fantastic! Give it to your DBT therapist, family members, yourself. This is the only book I have ever written a review for. HIGHLY RECOMMEND.

I’m posting it here for more than just shameless promotion of my book (click here for the post on “Why I Bothered to Write a Book”). I’m posting it to point out that people with BPD generally like my work and approach to BPD. That’s more than can be said of Stop Walking on Eggshells which I know from the borderlines who I know despise SWOE. The reason seems to be that in WHINE, I promote something that one of my list members calls the “Platinum Rule” of interpersonal behavior. The platinum rule states “treat others like they wish to be treated” (as opposed, of course, to the Golden Rule “treat others as you wish to be treated”). People with BPD and other emotionally sensitive people wish to be treated in a particular way. They respond positively to a certain way of treatment. Sometimes I get people comment on my methods as being too “easy” on the borderline, “letting the borderline win”, “giving into the borderline” or “not holding the borderline responsible for their actions”. The reality is that when a person is being treated like they wish to be treated, most of the poor behavior will fall away. When someone feels heard and accepted, there’s no need to scream and yell to be heard and accepted. I heard a borderline daughter once tell her mother “you only listen to me when I’m screaming at you”. That sort of thing goes away when you actually listen and accept the person and understand what they are really saying. I believe that much of the trouble between borderlines and their loved ones is due to a communication problem. Borderlines speak one language, their families speak a completely different language. WHINE really seeks to give you the tools to be fluent in the borderline’s (or any  emotionally sensitive person’s) language. Several people on my list have reported that when they started speaking the borderline’s language, the raging, yelling and abusive behavior ceased – in some cases almost immediately.

I like to sell books as much as any other author. Yet, sales is not the reason I write or continue to write, here and on the ATSTP list. In reality, I continue because I discovered something that worked really well for me and wanted to share it with other people who were in the same predicament I was in a few years ago. And, of course, this review also demonstrates that even borderlines like WHINE, so the dread that you may have experienced when your BPD partner finds SWOE might be mitigated if your BPD partner finds WHINE (and actually reads it).

See larger image When Hope is Not Enough (Kindle Edition) By (author) Bon Dobbs List Price: $7.50 USD Release date June 15, 2008.

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Splitting is not just for people with borderline personality disorder. Some (but not all) people who have expertise with high conflict personalities and borderline personality disorder (BPD) also think in black and white. In my opinion, when you read their books, blogs, message sites, and other forms of media, consider if they have a bias they are passing along–sometimes unknowingly, sometimes quite deliberately.

And goes on to say that these biases arise from stereotyping and:

But people with power to influence others need to allow for the complexity of these issues and not make stereotypes and generalizations.

I feel that Randi is actually doing the very thing that she is decrying here. Because she didn’t specify WHICH “people who have expertise” are “splitting”, I believe that her message can be interpreted as generalizing about these “experts” (myself included). I also feel the timing was interesting, because I have recently posted a few comments on her blog, clarifying my position on BPD and on being an effective non-BPD. Now, Randi assured me that that message was not directed at me. Yet, I believe that by not specifically enumerating the “bloggers and authors” in question, people will generalize and cast a wide net to include those bloggers and authors who DON’T have an agenda or a bias.

Additionally (and here is where I am really defending myself and explaining and clarifying), she cites 3 ways that she sees these bloggers and authors are biased. They are 1) generalizing and mind reading (I don’t think I do that), 2) Sexism (pretty sure I’m not in that category) and 3) Making people’s decisions for them (this is where the perception of my book and blog get a bit stickier). While I have never (that I can remember) told any non-BPD to stay or leave, there’s little question that my book When Hope is Not Enough: a how-to guide for living with and loving someone with Borderline Personality Disorder is a “staying” book. I mean, golly, just read the subtitle. In the introduction of WHINE, I say:

Unlike many books on this subject, this book starts with the premise that you want to continue to have a relationship with this difficult person. If you are a spouse, I assume that you want to stay married. If you are a parent, I assume that you want to continue a relationship with your child (sometimes you may have no choice). If you are a child of a parent with the disorder, I assume you want to learn how to effectively interact with your parent. Finally, if you are a friend, I assume you want to continue to be friends with this person. I do not cover how to sever a relationship with someone with the disorder in this book.

So, while I’m not telling people they SHOULD stay (or leave) or making the decision for them, my work assumes that they have already made the decision to stay and instructs the non-BPD reader of the book the ways (the know-how) in how I was able to transform my relationship with my borderline wife and daughter. I guess the only bias that I have is my own experience, which is staying with someone with BPD. I have no experience in leaving someone with BPD, although I do know many non-BPDs that have successfully left their BPD partner. Of course with kids and parents, the issue gets stickier still.

Finally, Randi says this:

It is clear from some people’s description of their own life–at least to me–that the relationship is unhealthy and needs to change. But in my opinion that must come from the non-BP themselves: list managers/authors/others don’t know if that person is using effective tools to improve the relationship.

I would agree with the first part of the clip, many Non-BPD/BPD relationships are unhealthy and need to change. The question is how? What does one DO to change the relationship? That is what I cover, based on my experience, in my book. The second part of the sentence, “list managers/authors/others don’t know if that person is using effective tools to improve the relationship” I actually have to disagree with. I have met hundreds of people with BPD and their loved ones, both electronically and in person, and have been trained in both DBT-FST (Dialectical Behavior Therapy Family Skills Training) and in Mentalization techniques. While I am NOT a mental health professional (and neither is Randi), I have “discovered” that a synthesis of these techniques, adapted for the partner/parent environment has worked wonders in my life. These skills are effective in a relationship with a person with Borderline Personality Disorder. Of course, you don’t have to agree with them and I have found several people that are unable to accept the skills from my book for various reasons. In WHINE, I say this, without realizing that for some people it would actually be impossible for them to implement these tools because the tools were counter to such strongly-held beliefs, the tools are rejected out-of-hand:

While some of the tools may be difficult to implement in your life and some may seem counter-intuitive, these tools are effective in managing a Non-BP/BP relationship. Depending on your background, biological make-up and sensibilities about the world, you may have an easier or more difficult time understanding and implementing these tools in your life.

I have also discovered that certain other skills are ineffective in the same context. Like any set of skills, these have to be practiced and practiced effectively and from the “proper” stance. They often say that “practice makes perfect” and sometimes people counter with the saying “perfect practice makes perfect”. I’m not one for the idea of perfection. I am one for the idea of agility and “second nature”. The thing is you’ll never hit the baseball out of the park if you don’t practice, with the proper stance, hitting a baseball. And furthermore , you’ll never hit the baseball out of the park if you’re swinging a kayak oar.

I think that Randi’s post actually has done some damage to the non-BPD “support community”. There are a number of individuals that are not mental health professionals and that fall into the “list managers/authors/others” category that in my opinion have been caught in the wide net that Randi has cast in that blog post. If non-BPDs can’t trust the people who now seem to have an agenda and are biased, who can they trust?

I’d just like to caution Randi with her own words: “But people with power to influence others need to allow for the complexity of these issues and not make stereotypes and generalizations.” She is a “person with power to influence others” because of the wide success of SWOE and her platform over at Psychology Today. Using this broad brush that creates doubt as to the motives of people who are actually attempting to help and share what worked effectively for them, does a disservice to the non-BPD support community in my opinion.

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It is most important to be effective (rather than right all the time)

This particular attitude is one that has been the most controversial in my Internet group. Many people in life pride themselves on their morals and ability to discern right from wrong. Many people try to do the “right” thing in any given situation. Sometimes people will do what they think is right, even if that hurts another person that is close to them.

People are typically very judgmental. Before I started down this path, I also was very judgmental. Sometimes I can still be judgmental. When I talk about judgmental, I am talking about judging whether other’s behavior is “right” or “wrong” in your eyes. It is the act of labeling other people’s behavior as “good” or “bad.” The problem with being judgmental when dealing with someone with BPD is two-fold. First, because of the shame involved in BPD, when a person’s behavior is judged as wrong or bad, the person will expand that judgment to his or her feelings and further expand it to his or her self. Therefore, a judgment of the other person’s behavior is essentially a judgment of the other person’s self. Secondly, the person is acting on their feelings and doing something that has, at one time in their life, been used to assuage negative feelings. They are acting in a way in which they will feel better. They are acting in a way that they have used to adapt to strong negative feelings in the past. While the behavior may be maladaptive, it is understandable behavior based on how the person feels. You might not behave in the same fashion, but if you had their history, thought like them, had strong negative feelings as they do; chances are you would behave in the very same way. Thus, judging their behavior as “wrong” or “bad” is missing the objective of the behavior. Yes, the behavior may be self-destructive or nasty, but the behavior is a tool for adapting to how that person feels.

One of the biggest problems with being judgmental toward someone with BPD is that it denigrates their feelings and creates the “invalidating environment” that I spoke about earlier. If you judge another person’s feelings (by way of their behavior) as bad, you are judging them as bad – at least for a highly emotional person.

It is extremely difficult to drop the judgmental attitudes that you have. It takes time and practice. Being judgmental is taught to us from a very young age and it seeps into our language. In some respects, we are taught that being judgmental is a positive thing, a moral attitude. We are taught not to accept others and their behavior because their behavior is bad or wrong. This attitude helps keep us within our social group and helps keep us from risk. However, in interpersonal relationships, particularly with a highly emotional person, it is corrosive. If someone feels they can’t be accepted “as is” and “for what they are,” that person will be either shameful or will fly into rage against the judge (or a combination of the two).

A sure sign of being judgmental is name-calling and labeling. If you find yourself, internally or externally (meaning to yourself or to others) labeling someone, you are likely being judgmental. I will talk about how to be less judgmental shortly.

I say, “It is most important to be effective.” What does it mean to be effective? Before I could talk about effectiveness, I had to dismiss being judgmental, because it is a roadblock to effectiveness. Being effective is doing whatever is necessary to gain a positive outcome in any given moment. In the case of emotions, it is doing what is necessary to feel better in any given moment. The major difference between effectiveness and mere adaptive behavior (as mentioned above) is that effectiveness takes into account the consequences that are associated with a given behavior, not just the immediate effects. That is where the idea of “positive” outcome comes into play.

In the case of emotional situations, sometimes the most “conditioned behavioral” response is not the most effective one. An example of this is self-harm. Most often, self-harm – such as cutting, burning oneself or pulling at one’s own hair – functions to reduce pain, not to inflict it. In other words, it is an adaptive response to internal (usually emotional) pain. While you might not think that the behavior is “right,” it is a valid response to internal pain, because it works to reduce pain. Although it is adaptive and “works,” it is not effective, because of the significant negative consequences involved. It can lead to embarrassment, injury, infection or death. The potential negative consequences outweigh the effectiveness of the behavior.

So, doing what “works” is not always the most effective solution to a problem. Learning to identify the most effective solution is a skill itself, and I will discuss it at length later. The point of bringing it up here is that one must adopt an attitude of doing the most effective action in any given situation. You have to be dedicated to being effective.

Now you might ask (as many of the people on my list ask), what if the most effective thing goes against my values? What if being effective is “wrong” in a particular situation? Well, my response to that is that emotions trump values. Emotions are immediate and primal, whereas values have been developed over time (sometimes over generations) and are more abstract than emotions. Again, this is not a case of “if it feels good, do it.” This is the accumulation of the first few attitudes I have directed you to take. If emotions are important (attitude #1), not all people think the way you do (#2), no one has a corner on the truth (#3) and some things have to be accepted (#4), what we arrive at is the attitude that your values and judgments are not necessarily valid for other people. If someone is overcome with powerful negative emotions, we find that: 1) it is important to them; 2) they are not thinking the same way you might; 3) your version of the truth in this situation does not match theirs; and 4) the fact that they are in this state is a truth and must be accepted. Once those attitudes are applied to an emotional situation, you can start to be effective, even if being effective goes against the grain of what you deem is “right” or “good.” I know this might be a difficult concept for you to understand at this point. It was extremely difficult for me to come to terms with it as well. However, in the case of emotional situations, it is essential.

OK, well there it is a long quote from When Hope is Not Enough. The reason I am posting it today is that I have come to understand more fully how this attitude conflicts with many strongly-held beliefs of my readers. It takes a LOT of time to understand and “grok” this approach to life and to your relationships with a person with BPD or any emotionally sensitive person. Once, I was asked what qualities do I dislike the most about other people and I answered: contempt, sanctimoniousness and judgmentalism. I feel that all of these qualities are those that hurt relationships with other people and they all center on the idea that person A (with those qualities) is RIGHT and person B is wrong, for whatever reason. That reason could be that person B is disordered, like have Borderline Personality Disorder. However, person B is no BPD, person B is a person first and can be respected as a person. I read recently an introduction written by the Dalai Lama to a book. His first words were “Every person wants to be happy.” I agree. A person with BPD wants to be happy. The nons want to be happy as well. Yet one stumbling block to happiness is the desire to be right and lord it over the other person. Relationships are not competitions in which one person is right and the other wrong. That’s my belief anyway. When you’re ineffective, what you’re really doing is “winning a battle but losing the war” by gaining points on a particular situation yet hurting the relationship in the longer run.

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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.

Dr. Marsha Linehan, the developer of Dialectical Behavior Therapy (DBT), states it this way:

The components of emotion vulnerability are sensitivity to emotional stimuli, emotional intensity, and slow return to emotional baseline. “High sensitivity” refers to the tendency to pick up emotional cues, especially negative cues, react quickly, and have a low threshold for emotional reaction. In other words, it does not take much to provoke an emotional reaction. “Emotional intensity” refers to extreme reactions to emotional stimuli, which frequently disrupt cognitive processing and the ability to self soothe. “Slow return to baseline” refers to reactions being long lasting, which in turn leads to narrowing of attention towards mood-congruent aspects of the environment, biased memory, and biased interpretations, all of which contribute to maintaining the original mood state and a heightened state of arousal.

Essentially what you’re dealing with is someone who reacts strongly and emotionally to the slightest provocation, who will dwell on those intense emotional reactions for periods longer than you might. A person with BPD-like traits heats up quickly and cools down slowly. I’m sure that if you have been dealing with such a person for an extended period of time, you will have noticed that she seems to fly off the handle at the slightest comment or action, no matter how unintended the “offense.”

Someone with BPD will be more sensitive to emotional cues and triggers from the environment, will react more intensely to these cues, and will take longer to “return to baseline,” or will be under the effects of strong emotions for longer than other, less emotionally-reactive people. Many times, because of the low tolerance for emotional cues or triggers, the person with BPD will react with alarm even though their emotional reaction does not match the reality of the environment.

We all have emotions and react emotionally to events in our lives. That’s one of the things that makes us human and that we all share – disordered or not. What separates us is our emotional profile. A person with BPD gets into powerful emotional states more easily than other people, and her reactive period lasts longer than with other people. A person with BPD is like a cork floating on a stormy sea of negative emotions and her emotional profile is like a volcano. Yet, one has to understand that the emotions feel as real as any other emotional reaction even if the intensity is high. A person reacting to emotional states will, for the most part or until they train themselves to do otherwise, react in the natural fashion that anyone would react to strong emotions: attack with anger, flee with fear, withdrawal with sadness and rejoice with joy.

(adapted from When Hope is Not Enough)

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Mind Reading: Psychologist Simon Baron-Cohen on Empathy and the Science of Evil
By MAIA SZALAVITZ Monday, May 30, 2011

Cambridge psychology professor and leading autism expert Simon Baron-Cohen is best known for studying the theory that a key problem in autistic disorders is “mind blindness,” difficulty understanding the thoughts, feelings and intentions of others. He’s also known for positing the “extreme male brain” concept of autism, which suggests that exposure to high levels of testosterone in the womb can cause the brain to focus on systematic knowledge and patterns more than on emotions and connection with others. (Oh, and yes, he’s also the cousin of British comedian Sacha “Borat” Baron Cohen.)

Baron-Cohen’s new book, The Science of Evil: On Empathy and the Origins of Cruelty, examines the role of empathy, the ability to understand and care about the emotions of others, not only in autism but in conditions like psychopathy in which lack of care for others leads to antisocial and destructive behavior.

What do you mean when you write about “zero negative” empathy?

Zero empathy refers to people at the extremely low end of the scale. They tend to be people with personality disorders, particularly antisocial personality disorder (ASPD). I focus quite a lot on psychopathy [the extreme form of ASPD] and also on two other personality disorders, borderline personality disorder and narcissistic personality disorder.

The ‘negative’ is meant to be shorthand for this being negative for the individual but also for the people around them. It’s meant to contrast with what I call ‘zero positive’ empathy, which effectively describes the autistic spectrum.

[Autistic people] struggle with empathy just like zero negatives but it seems to be for very different reasons. I’m arguing that their low empathy is a result of a particular cognitive style, which is attentive to details and patterns or rules, which in shorthand, I call systemizing.

If we think about the autism spectrum as involving a very strong drive to systemize, that can have very positive consequences for the individual and for society. The downside is that when you try to systemize certain parts of the world like people and emotions, those sorts of phenomena are less lawful and harder to systemize. That can lead to having low empathy, almost like a byproduct of strong systemizing.

How do you account for people who are both highly empathetic and highly systematic, such as some of those with Asperger’s who are actually oversensitive to the emotions of others?

I’ve certainly come across subgroups like that. There are people with Asperger’s whom I’ve met who certainly would be very upset to learn they’d hurt another person’s feelings. They often have very strong moral consciences and moral codes. They care about not hurting people. They may not always be aware [that they've said something rude or hurtful], but if it’s pointed out, they would want to do something about it.

The other side of their moral sense is that they often have a strong sense of justice or fairness. They may have arrived at it through looking for logical patterns rather than necessarily because they can easily identify with someone, however.

People often think that autistic people are dangerous, like psychopaths, when they hear this idea that they have “no empathy.”

In a way, that was one of my motivations for writing the book. Low empathy is a characteristic of many different conditions or disorders. Often books are written where they either focus on psychopathy or autism but [not both].

We have to look at them side by side, and when we do that, we see that they are very different and it’s important to bring that out.

Is it the case, then, that autistic people are not good at the “mind reading” part of empathy, in terms of predicting people’s behavior and feelings, while psychopaths are able to do that but are not able to care?

I think the contrast between these two conditions provides some evidence for that dissociation within empathy. People with psychopathy are very good at reading the minds of their victims. That’s probably most clearly seen in deception. You have to be good at mind reading before it would even occur to you want [to deceive someone]. So you can see the cognitive part of empathy as functioning very well, but the fact that they don’t have the appropriate emotional response to someone else’s state of mind, the feeling of wanting to alleviate distress if someone’s in pain, [that suggests that] the affective part of empathy is not functioning normally.

What stunts the development of empathy in personality disorders?

In the book, I explore both early environmental factors and biological and genetic factors. I think it’s particularly clear in borderline personality disorder (BPD) that there’s a strong association between early environmental deprivation and neglect and abuse and later outcome of BPD. There’s an association [with abuse and trauma early in life] in psychopathy, but it’s not strong as in BPD.

What defines borderline personality disorder?

There seems to be quite a lot of difficulty in self-regulation, in the regulation of their own emotional state. A lot of people with BPD also have depression. Many are suicidal. Many have had a history of feeling attacked or uncared for’ they are almost hypersensitive to possible threats from others.

They react almost with a hair trigger — if they perceive they are being attacked, they go on the attack. People with BPD can be so preoccupied by their own sense of not being cared for and not being understood that they can become blind to the impact of their own behavior on others.

So how would you address increasing empathy in these conditions?

There are interesting and imaginative new approaches to treatment for empathy. Some are medications like oxytocin. Some are psychological treatments like Peter Fonagy’s work on mentalization therapy. I haven’t ever watched it done but the idea is to encourage the patient to stop and think about others’ thoughts and feelings. It’s particularly useful for BPD. When someone with that condition is mostly focusing on themselves, the therapist prompts them to take other people’s perspectives. And just through repetition and practice, people get better and better.

I don’t see how that would work with psychopaths.

People are doing some clinical approaches with psychopaths too, like getting them to meet their victims. That’s obviously got lots of traumatic risk attached to it [for the victim], but again, it’s an exercise in perspective-taking.

I think if we take seriously the idea that behavior is the result of the brain — that having low empathy [is] the result of the way the empathy circuit is functioning or has developed — it does raise moral questions. When someone is acting with low empathy, why do we judge them as bad and punish them? It does shift the locus of where [they should be treated] philosophically, from the criminal justice system to health care.

Don’t you think there are people who are actually evil, who know what they’re doing is wrong and harmful but choose to do it anyway?

I argue in the book that I don’t find the term evil very useful. Once you are down at zero degrees of empathy, all kinds of behavior become possible. I don’t find it scientifically useful to use that term. Empathy is a scientific term in a way that evil isn’t. You can try to localize it in the brain; you can look for which part of brain is activated. It’s normative behavior. Evil is kind of the opposite of good, I guess, but empathy, as we were talking earlier, is quantifiable and normal. You can measure it and look for it, whereas you don’t see evil in the brain.

It’s argued that humans were able to evolve cooperation and altruism only by having a way to detect and punish those who didn’t cooperate.

I could see an evolutionary benefit for both empathy and lack of empathy too. Low empathy allows you to act selfishly, which could be in your interest, but high empathy fosters social cohesion and it’s good for the individual to end up as part of a social network.

I speculate that maybe most people end up in the middle, which may be the optimal position. It’s good to have some empathy, so at the very least you avoid offending or inadvertently hurting someone, but too much empathy might mean never completing your own projects.

How does your cousin Sacha Baron Cohen, creator of Borat, rate on empathy? His work can really make you cringe, but he must be excellent at mind reading to do it.

First of all, he and I have a family agreement that we don’t talk about each other. I respect his work. I think that sometimes that kind of comedy can create what you called a “cringe reaction,” cringing with embarrassment, but that has a purpose.

Why does empathy seem especially lacking in the teen years?

It’s kind of interesting that parents comment on adolescence as being a low point in empathy. But there’s still quite a lot of maturation going on in the part of the brain that involves empathy during that period. There could also be hormonal factors, particularly in males with the increase in testosterone. That could change empathy levels.

I’m struck that if you look at the “terrible two’s,” kids who have tantrums when they don’t get their way, and teens, at one level it looks like very little development has gone on. There’s a transition at around age four to becoming able to apprehend that others have different perspectives. You would imagine that empathy would almost reach a peak in early childhood, but it seems to have a long protracted development.

It seems to me that the terrible twos and adolescence are both the most intense periods of brain development. Could that be why empathy is impaired then?

That’s really interesting. I think brain maturation is one thing and also just the experience of relationships. I think that empathy has to have an environment in which to work, and that environment is relationships. Making mistakes in relationships is all part of learning to empathize.

There was an interesting study I was part of. Women who took extra testosterone were given the ‘reading the mind in eyes test.’ [The test measures how well people can read others' emotions by looking at their eyes.] A dose of testosterone lowered scores on this test. It was one of the first demonstrations that changing testosterone levels affects your empathy.

If you’re taking an evolutionary approach, it might be very adaptive if you have to use aggression for self-defense. You’d be more effective if you didn’t have empathy getting in the way.

A U.S. doctor tried to treat autism by lowering testosterone levels, citing your work as justification, although he actually didn’t get the research right. He just lost his license because he was using a “chemical castration” drug on kids to do this.

We haven’t considering [lowering testosterone] as a treatment to study for autism. I’m not comfortable with it ethically in terms of side effects. They misquoted [our research], and cited it as evidence that there was elevated testosterone in autism when, in fact, we haven’t shown that. They presented it as if we’re endorsing it, which I’m certainly not.

See more of Healthland’s “Mind Reading” series.

Find this article at:

http://healthland.time.com/2011/05/30/mind-reading-psychologist-simon-baron-cohen-on-empathy-and-the-science-of-evil/

You can buy to book here:

See larger image The Science of Evil: On Empathy and the Origins of Cruelty (Hardcover) By (author) Simon Baron-Cohen List Price: $25.99 USD New From: $13.92 In Stock Used from: $9.88 In Stock

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See larger image When Hope is Not Enough (Paperback) By (author) Bon Dobbs List Price: $19.95 USD New From: $18.21 In Stock Used from: $17.30 In Stock

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Potty training provides an excellent example of positive reinforcement and the ignoring of “backsliding.” That is the essence of this tool. When you teach a child to use the potty, you make a BIG positive deal about it when it is successful. The first time you see the poop in the potty, what happens? Typically, the parent praises the child, positively reinforcing the behavior in a way that is out-of-proportion with the accomplishment. You may say, “Yeah! You did it! That’s fantastic! Good Job!” and clap your hands and cheer. You also will tend to do it within seconds of the completed behavior. That is where positive reinforcement differs with general praise. Praise can be given much after the fact and can be bestowed for a number of reasons, including character traits. That is, you could say, “Wow, you are so smart” after your child receives a 100% grade on a math test. That is praise. (Although I’m not sure it is effective, but that is not the topic at hand). Positive reinforcement is for behaviors and should occur right when the behavior is completed. That is how animals are trained. The positive reinforcement (feeding, for example) occurs within seconds of the completed behavior so that the two can be connected in the mind of the animal.

If I return to potty training, you will notice that you also naturally ignore and don’t punish behaviors that don’t match the desired behavior. That is, if the child has an accident and poops in his/her pants (while not wearing a diaper) you don’t say, “You are a naughty little boy/girl!” No, that would be damaging to your child’s self-image. No, instead, you say, “Everyone has accidents at first. You can try again next time. It’s OK.” This is an accurate corollary to emotional regulation and reinforcement and punishment. Since the BP naturally has difficulties regulating her emotions, the idea of her “messing up” or “backsliding” is analogous to child pooping in her pants (even if this is more the “rule” than the “exception” in the BP’s life). It is not effective to punish her for behaviors that (at first) she can’t control. The behaviors are conditioned and the purpose of this tool is to help recondition a BP to behaviors that are more desired and effective. After conditioning, the child is able to control (or at least sense) when she has to go potty. After conditioning a BP is able to control (or at least sense) when she is becoming dysregulated.

- An excerpt from When Hope is Not Enough: a how-to guide for living with and loving someone with Borderline Personality Disorder. Available online in Print, eBook and Kindle
Editions

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Sometimes Hope is Not Enough

Bon Dobb’s book, “When Hope is Not Enough” is bar none, hands down the single best how-to book I’ve ever read. I wish I were more eloquent, for this book deserves a far better review than I am able to offer. Out of the dozens of relationship books I’ve read over the last three and half years, this is the ONLY one that actually made a difference. My wife and I were on the verge of divorce and I had just moved out of the house when someone turned me onto Bon Dobb’s book. I read it in two days and, when my wife called me on the evening of the second day, I put his suggestions into practice. Following his techniques stopped the fight and took our marriage to a whole new level of intimacy and communication. Of course, it will take a lot of practice to perfect all the techniques he offers, but saving my marriage is worth all the time and effort I can give it.

If you’re a man, having troubles in your marriage, this is the first and best book I could recommend.

That’s a really nice review of the book and I’m totally glad this guy got results from the book. I certainly never expected anyone to call the book the best how-to book they’ve ever read. As one of my ATSTP Group members once said: this sh*t works!

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See larger image But I Love You (Kindle Edition) By (author) Bon Dobbs List Price: $4.99 USD Release date April 25, 2011.

My “primer” book But I Love You is now available as a Kindle eBook. Like my other two books: When Hope is Not Enough (the big, green book) and Beyond Boundaries (the advanced guide) you can now read But I Love You on the Kindle. A note about But I Love You:

This “primer” grew out of my book “When Hope is Not Enough: a how-to guide for living with and loving someone with Borderline Personality Disorder.” If you have read that book, you will not find much new material in this one. There are a couple of new things (most notably, the “cheerleading” tool), which do not appear in “When Hope is Not Enough.”

This primer was born out of frustration about “When Hope is Not Enough.” One of my list members (of the “Anything to Stop the Pain” Google Support List) found that she and her husband were having trouble understanding the structure of “When Hope is Not Enough.” They felt that many of their “burning questions” were answered only in the end of the book. They have an adult daughter with BPD and wanted to know answers to questions like “Why does she constantly lie to us?” and “Why does she react with rage when we
make innocent suggestions?” The problem that they found with the full “how-to guide” was that way in which I presented the material. In “When Hope is Not Enough” I present a model of BPD that is initially more “inwardly” focused on a person with BPD’s feelings, reactions and motivations. The three core components of BPD that I present in my previous book are: emotional dysregulation, shame and impulsivity. These aspects are, in my opinion, the drivers of all of the behaviors, as crazy as some of these behaviors seem to us.

However, these aspects are all internal to the person with BPD and, as parents of an adult daughter with BPD, my list member and her husband wanted to understand their daughter’s behavior from the “outside in” more fully.

“But I Love You” explains a loved one with BPD in a way that speaks to this frustration with “When Hope is Not Enough.” I see it as a stepping-stone to understanding the full “how-to” guide.

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Stacy on the label Borderline Personality Disorder:

When I first heard of BPD, it was in a magazine article given to me by a college roommate.  That was back in the early ’90s, and the article said BPD couldn’t be cured, so I either had to resign myself to being crazy forever or dismiss the diagnosis as a way of marginalizing women who refused to be meek and subservient.

My initial reservations about the diagnosis, with which I continued to struggle until I found DBT and, therefore, hope, centered around the question of whether you could diagnose any strange, artistic, outspoken girl with the disorder.  I had a lot of legitimate anger over growing up marginalized, and I had a hard time separating that anger from the maladaptive rages that derailed my life for so many years.

Meeting my DBT therapist and reading Marsha Linehan’s work helped me make peace with the diagnosis and to see it as valid.  When I read the DSM criteria and realized I was nine for nine, I had to admit there was some truth there.  It really was like seeing an outline of my life.  By that point, I wanted so desperately to get better, to build a life not punctuated by constant bingeing and purging and starving and suicide attempts, that I was willing to call my illness whatever I had to call it to get treatment.

As for what borderline means to me today, it is an accurate description of a disorder from which I feel mostly recovered.  I encourage anyone who feels the diagnostic criteria ring true to pursue an official diagnosis and seek out the treatment for which they qualify.

Stacy on relationships as triggers (a study by Dr. Paul Links showed that relationship events are the #1 most important trigger for borderlines):

Relationships were my primary triggers. I wanted so desperately to be loved, validated and saved from my loneliness that I latched onto a string of partners who showed intense initial interest, and I promptly scared them off with the depth of my neediness.

I also had a propensity for seeking out emotionally abusive or withholding lovers. Relationship after relationship ended in emotional flameouts and trips to the emergency room for overdoses. When I entered DBT, I realized this was something I had in common with most of the other women in my treatment program, and I was able to let go of some of the shame I felt about it. Learning that this particular brand of self-destruction was a hallmark of my disorder gave me hope that I could use my DBT skills to avoid forming unhealthy attachments in the future.

Stacy on DBT (and mood stabilizers):

It’s a totally different world!  Life before DBT seemed hopeless, and now it seems exciting and full of possibility.  I trust myself to navigate the storms of day-to-day existence.  Thanks to the DBT distress tolerance and emotion regulation skills, I even weathered a breakup without a suicide attempt, and know that if I ever see my ex again I can hold my head up and feel no shame or guilt over my behavior. I’m really proud of that.

The mood stabilizer Lamictal has also been a godsend.  My moods now swing between happy and sad, not ECSTATIC and SUICIDAL.  Needless to say, I’m a fan.

See larger image Loud in the House of Myself: Memoir of a Strange Girl (Hardcover) By (author) Stacy Pershall List Price: $24.95 USD New From: $12.45 In Stock Used from: $10.51 In Stock

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IAAHF

As you can see, I also get lots of searches on “famous people” or “celebrities” with BPD. I only post those types of articles to relate to those with BPD and their families that perhaps they are not alone in their struggles – perhaps (again it’s a maybe because the closest celebrity to actually come out and say he/she has BPD is Megan Fox – who speculated about it).

I’ve written a lot about IAAHF here. I also explain the concept and how it relates to validation skills in the I-AM-MAD communication skill. The concept of IAAHF is extremely important to fully understand if a non-BPD is going to understand what is going on in the emotionally dysregulated moments (EDMs). It takes some time to understand and to truly “get” it. For me, it was one to the most valuable perspectives on BPD and emotional dysregulation.

Sometimes, however, nons have a problem with this concept because they misinterpret it. Here is a brief note from “When Hope is Not Enough” (the second edition, on which I am working) about IAAHF:

I found that many people bristle at the idea that it’s “all about” the borderline’s feelings. Sometimes this formulation makes the Non-BPD’s ask: what about my feelings? (which, in a way, is a reformulation of “what about me?”). The intention of this concept is for you to understand the motivation of behavior, not the entire landscape of the relationship. There will be times in which the context of the relationship is about your feelings. Yet, when the “crazy” behavior takes place, it is most often motivated by dysregulated feelings and emotions. The purpose and intent of the behavior is to quell those feelings, even if it seems as if it’s your fault that those feelings exist. To understand and use this attitude properly, you have to remember that it’s (the behavior) is all about (motivated by) his/her feelings (dysregulated emotions that require calming/quelling of pain).

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Books Read by Non-BPDs

OK, here’s a better representation of the percentage of the responders, rather than the % by total answers:

Books by Responders

I also have started a new poll about self-injury. I am quite interested in the stats on self-injury because I have been told time and time again that MOST BPDs do NOT engage in self-injury. I guess we’ll see in the unscientific way that we do here.

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Here is the text of the article, as seen on the Huffington Post:

Russell Bishop Author, Consultant, Executive Coach
Posted: March 7, 2011 06:10 AM
Why You Should Never Defend, Explain or Justify

Why do some people seem to be forever defending, explaining or justifying themselves? Do you enjoy being around this person? Are you one yourself?

Quite the opposite from the critics who have been the subject of recent articles on complaints and criticism, this person becomes tiresome not because of a string of complaints, but more because of the somewhat toxic nature of self-defense.

Years ago, as the personal transformation wave was cresting via large group seminars, several of us started using a made-up word to highlight the toxic nature of self-defense and explanation: dexify. The word even seems to connote something toxic all by itself.

Certainly, someone who engages in dexification (there’s another use that may suggest something kind of dark) seems to be sliding down a spiraling path of negativity. What’s so negative about defending yourself, you might ask?

On the one hand, nothing really, especially if there’s something there to defend. However, I am not referring to the kind of self-defense you might need when wrongly accused of something, especially something heinous or criminal. However, there’s a difference between that kind of self-defense and the more common defend-explain-justify behavior that many of us seem to engage in almost daily.

To be fair, I know I have certainly done my fair share of dexification. The main problem in day-to-day life is that when you choose to dexify, you almost always sound guilty-as-charged. I know that when I find myself in justification mode, there’s almost always some part of me that feels insecure about the area, perhaps even wondering-fearing-believing that it must be true.

There may well be several moving parts here, but allow me to underscore a critical aspect that may be operative and why dexification is usually not all that helpful. The worst possible scenario might be that the criticism is accurate and I’m simply digging myself a deeper hole by dexifying.

Some time ago, I wrote an article on this subject, citing a lesson learned from Bucky Fuller about how we can benefit from our perceived enemies. The gist of the story: after a wonderful lecture on the value of seeking to understand and be understood, Bucky took questions from the audience. One gentleman took the microphone and proceeded to tell Bucky that he was full of beans, didn’t know what he was talking about, and had no basis for his point of view. Bucky considered the comment, and replied, “Thank you.”

After a couple of more rounds of this kind of exchange-attack, wherein the gentleman kept going after Bucky, trying to provoke a reaction, Bucky taught us all a great lesson in self-awareness by saying something like this:

Did you not notice that each time I paused to consider what you had to say? I looked inside myself to see if some part of me was reacting to what you had said about me, particularly if some part of me were upset, prone to counterattack, or otherwise affected. I have found that when I am in that kind of reaction, there is typically something there for me to learn about myself, something for which I need to improve. In this instance, I found no reaction. Thus, you were simply sharing your opinion to which you are fully entitled and with which I have no argument. Therefore, “Thank you” seemed most appropriate.
Indeed, Bucky Fuller demonstrated considerable self-awareness and personal integrity throughout his life, and this little exchange has been a guiding light for me for years. Learning to see the reaction inside myself as feedback about me, pointing out areas of growth, not something to be defended, has been both expansive and liberating for me.

I have learned that when I feel the need to dexify myself, some part of me is almost always of the opinion that they must be right and I must be wrong. The defending, explaining and justifying never seems to change anything and, instead, tends to anchor me more deeply in the issue that needs to be addressed.

If you recognize this tendency in yourself, here’s a little tip that I have found personally useful whenever I have the courage to use it. Courage, by the way, is an interesting word that typically means something about physical or mental strength or bravery. Its roots, however, go to the Latin and French words for “heart.” I have heard it said that the suffix of the word, “age,” means something like “wisdom.” If you put the two together, you get “the wisdom of the heart.”

The next time you find yourself under attack and are about to resort to dexification, consider the wisdom of your own heart. Look inside yourself to your own reactions. If, like Bucky, you find yourself in reaction mode, consider that there might be a kernel of truth here for you, perhaps an entire bushel-full. If there is something there, then draw a bit more on that source of heartfelt wisdom and dive into the question even further, perhaps saying something like, “That’s very interesting. Can you say some more about what you see or how you see this playing out in my behavior?”

I know that for many this seems somewhere between silly and incomprehensible. Why on earth would you invite even more criticism, especially in an area where you might already feel uncomfortable?

It’s simple, really. You just might learn something that will liberate you. You may find yourself growing in confidence and inner strength as you choose inquiry over dexification. You might also wind up closing a gap between you and the other person. After all, it does take great courage to step closer in the face of criticism, and your sincere inquiry may melt away something that prevents you from being even more effective.

***
Please leave a comment here or drop Russell an e-mail at Russell@russellbishop.com.

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Sometimes Love Hurts

I’m currently reading the book ‘The Essential Family Guide to Borderline Personality Disorder’ by Randi Kreger. This is the first book I’ve read on the subject & I’m finding it really helpful.

I started to research other books and found the one I’m ‘reviewing’ on the US Amazon website. There are lots of reviews of the book there and it made me decide to buy it as the reviews are very positive. So, if you want to read reviews before you buy this book, have a look on the American site.

I’ve now read the book! Just this minute finished reading it in fact. I have found it so very very helpful, not just with the tools Bon Dobbs gives you for improving your relationship with your BP loved one, but for improving their experience of life. It’s a book for being a kinder, more understanding, more enlightened person in all relationships I think.

The first book I read by Randi Kreger (mentioned above) was more about looking after yourself when in a relationship with a BP. Bon Dobbs’ book is about looking after them too. He says “a BP’s brain is working against them by upsetting the emotional regulation system. It is impossible for a BP NOT to feel those emotions. The emotions are not right or wrong, they just ARE. It is the behaviours that arise from the emotions that can be changed, and that is where we will focus our attention.”

The book is very practical and very intelligently and insightfully written, based on years of experience of living with 2 family members with BP (wife & young daughter). I am so grateful to the author for so generously sharing his experiences and the ways he’s found to improve life for his wife, daughter, the rest of the family & himself.

I have learned so much about why my own loved one developed BPD in the first place and what I can now do to help alleviate some of the suffering that goes with this condition.

The title ‘When Hope is Not Enough’ sounds a bit bleak, but what the book has given me IS huge hope! I now very clearly understand that my loved one needs validation of their feelings. The author has shown me that validating their feelings in no way compromises my own core value of acting with integrity – rather, it will enhance it.

The reason I find this review interesting is two-fold (beyond the thank-yous and the nice words about me): 1) I believe that the reviewer is correct about the nature of my book – it is for the relationship, not for the non-BP exclusively and 2) The reviewer is also right about the fact that you can enhance the relationship, through validation and other tools, without sacrificing your own value or values.

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See larger image When Hope is Not Enough (Kindle Edition) By (author) Bon Dobbs List Price: $7.50 USD Release date June 15, 2008.

I am pleased to announce that When Hope is Not Enough: a how-to guide for living with and loving someone with Borderline Personality Disorder is now available in the Kindle format in the United States and in the UK. I had been asked about getting this book on the Kindle and I finally figured out how to do it. I should have my other books on the Kindle format shortly. If you have a Kindle, now you can read the Non-BPD book that has helped hundreds of people in their relationships.

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See larger image Overcoming Borderline Personality Disorder: A Family Guide for Healing and Change (Paperback) By (author) Valerie Porr List Price: $24.95 USD New From: $15.03 In Stock Used from: $11.49 In Stock

Overcoming Borderline Personality Disorder by Valerie Porr is perhaps the most up-to-date and complete book for family members of people with BPD published to date. When I read the book, I couldn’t help but think that Ms. Porr had the therapists and mental health professional more in mind than the family members. It appears as though she is trying to dispel many myths about BPD that exist not only in the family environment but also in the mental health community. This book is steeped in scientific research, including research involving the biological under-pinnings of BPD. It includes many skills for family members from both DBT and mentalization based therapy (MBT). Clearly Ms. Porr is highly respected by the clinical community since many of the leading experts in research and practice in BPD treatment have written blurbs for this book. The book is quite dense and a must read for family members of those with BPD. Yet it might not be the best book to start with because of the complexity of the scientific research, the psychoeducational aspects and the technical details about the various therapies for those with BPD. Still, I highly recommend Overcoming Borderline Personality Disorder.

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Emotional Idiot
Maggie Estep

I’m an Emotional Idiot
so get away from me.
I mean,
COME HERE.

Wait, no,
that’s too close,
give me some space
it’s a big country,
there’s plenty of room,
don’t sit so close to me.

Hey, where are you?
I haven’t seen you in days.
Whadya, having an affair?
Who is she?
Come on,
aren’t I enough for you?

God,
You’re so cold.
I never know what you’re thinking.
You’re not very affectionate.

I mean,
you’re clinging to me,
DON’T TOUCH ME,
what am I, your fucking cat?
Don’t rub me like that.

Don’t you have anything better to do
than sit there fawning over me?

Don’t you have any interests?
Hobbies?
Sailing Fly fishing
Archeology?

There’s an archeology expedition leaving tomorrow
why don’t you go?
I’ll loan you the money,
my money is your money.
my life is your life
my soul is yours
without you I’m nothing.

Move in with me
we’ll get a studio apartment together, save on rent,
well, wait, I mean, a one bedroom,
so we don’t get in each other’s hair or anything
or, well,
maybe a two bedroom
I’ll have my own bedroom,
it’s nothing personal
I just need to be alone sometimes,
you do understand,
don’t you?

Hey, why are you acting distant?

Where you goin’,
was it something I said?
What
What did I do?

I’m an emotional idiot
so get away from me
I mean,
MARRY ME.

You can buy Maggie Estep’s “Diary of an Emotional Idiot” below:

Diary of an Emotional Idiot

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Clearly, the reviewer didn’t understand the idea of emotional dysregulation or the difference between motivation, intent, action and consequence. I attempted to separate and explain each concept in the book, but perhaps I did a poor job.

In “When Hope is Not Enough” I write about the concept of IAAHF (or “It’s all about his/her feelings”). That statement, which is an exploration of the idea “it’s not about you,” is a statement of intent and motivation, not a release from the consequences of someone’s actions. The “all about” statement concerns the motivations of a person with BPD’s actions – that is, rarely does someone with BPD intend to hurt the non-BPD, despite appearances. What the intention of this statement of intent seeks to do is release the non from the paranoia that their loved one with BPD is out to get them. This is typically not the case. Usually, the actions of a person with BPD are intended to reduce their own emotional pain (stemming from emotional dysregulation). Sometimes this emotional pain and emotional dysregulation is triggered by (what I call) perceptions that are “misaligned” with the situation. That is, the “attack” on the borderline is not intended by the non to be an attack at all and through a highly sensitive emotional profile and emotional dysregulation, the borderline will attack back as a way of defending their self from a perceived attack. But the real point here is that the motivation and intention of the borderline’s attack is actually to quell the painful feelings within herself, not to cause interpersonal strife or manipulate the non.

However, as I also say in “When Hope is Not Enough”, the action (or cause) sometimes has unintended consequences (or effects). When a borderline is emotionally dysregulated and overcome with feelings, the action that she takes is likely to be impulsive and the consequences of her actions are not taken into consideration. When behaving this way, the borderline will often behave in an “effect -> cause” way – meaning she will think “I feel bad, so you must have done something to specifically make me feel bad.” If a borderline is to consider the consequences, even the unintended ones, of her actions, she will need to approach the situation in a “cause -> effect” way. Intentions do not provide a free pass for consequences. As I have said on the ATSTP list, just because you didn’t intend to burn down the house while playing with matches, doesn’t bring the house back into existence when you express your intention. One thing that separates the understanding of consequences (that follow from a cause – and in this case the cause is the behavior of the borderline) from blame is that there is an analysis based on observation as opposed to judgment. If you feel that the borderline has done something “wrong,” then you are inserting your judgment, rather than understanding the observed consequences of the behavior. I tried to explain this fully in “When Hope is Not Enough”, but I suppose some people either are so caught up in fault-finding and blame-storming that they can’t separate judgmental thoughts from the understanding of consequences or I have expressed it poorly in the book. If a borderline can begin to understand the consequences of her actions (and especially powerful are those that go against her goals), then, in my mind, the borderline can become responsible for her actions and do so in an effective manner.

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When Hope is Not Enough discounted for the holidays

Just in time for the holidays, I am offering a 25% discount on the Publisher’s version of When Hope is Not Enough. You can now buy the book directly from the publisher for only $14.96! That 25% off the retail price and cheaper than buying it at Amazon. This deal will only be valid through the end of the year. To buy the book at this price follow this link:

http://www.lulu.com/product/paperback/when-hope-is-not-enough/2994088

If you need some skills to help you through the holidays, read this post.

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When Hope is Not Enough
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staying and working on the relationship

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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.

They go on to say this:

It is noteworthy that many symptoms in the interpersonal domain of borderline personality disorder are actually manifestations of intrapersonal difficulties (e.g., difficulty being alone and misperception of the intentions of others as malevolent), and this dimension could perhaps be reconceptualized as “intrapersonal dysfunction.” We suggest that an internal feeling of well-being, stability, and self-regulation in borderline personality disorder is tenuous and may rely heavily on a sense of interpersonal contact and connectedness.

So, what’s afoot here? What are they saying and what does it mean to the nons of the world?

It seems to me that they are saying two very important things about BPD that has previously been “unnoticed” as DBT has reigned the clinical community. These are:

• “…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.” Basically, that the interpersonal sensitivity is the “control” of is sensitive to the (emotional) heat.
• “We suggest that an internal feeling of well-being, stability, and self-regulation in borderline personality disorder is tenuous and may rely heavily on a sense of interpersonal contact and connectedness.” That means that the lack of internal well-being makes the person with BPD sensitive to interpersonal cues.

What do those two important factors mean to you – the loved one or family member? In my mind they mean that a person with BPD uses people in close personal relationships to self-regulate. In other words, being unable to self-regulate internally, they look to external people to regulate their emotions, reactions, sense of well-being and behavior.  They believe at some level that you, the loved one, is an extension of their mind, emotions and feelings and assume to you “should know what to do” when they are feeling dysregulated.

What SHOULD you do when this situation occurs? What should you do when they are triggered? What should you avoid?

I believe that the most effective answer is to help them learn to self-regulate and self-validate. This “lack of well-being” is an unpleasant feeling (I would imagine) and probably feels like a HUGE lack of control. I mean, if a person has to rely on other (unpredictable) people to self-regulate, how must that feel? Having compassion for that feeling is definitely a goal. However, before that comes (and it can be cultivated BTW), one can listen, ask, redirect the choice, validate, normalize and cheer lead when appropriate. Don’t defend or minimize. Living a life in which you’re always waiting for the other shoe to drop has got to be unpleasant.

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When Hope is Not Enough Hits #5 on Lulu/Amazon List

When Hope is Not Enough
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staying and working on the relationship

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When Hope is Not Enough reaches number 10 for May sales Lulu books

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http://www.novelrank.com/title/when-hope-is-not-enough-paperback

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I wanted to post a couple of observations about the new edition as well as some of the experiences that I and others have had with the book. My basic feeling about the book is that it is NOT a book to be used for staying with someone with BPD. SWOE is a book about YOU and YOUR feelings. It is a book that placates the Non-BPD person. That is fine, since that is the audience of the authors (which is probably why it has sold so many copies that and because it has a great title), yet people must realize that SWOE can’t be used to engender a trusting, loving relationship with someone with BPD. The evidence of this is in the subtitle: Taking back your life when someone you care about has borderline personality disorder. This is what I have observed from users of SWOE and the methods contained therein:  sure, you take your life back, but the relationship with the person you care about with BPD is wrecked.

Why?

Because SWOE is all about you. It is understandable that the authors created a book like this. I mean, how many of us Nons have asked “what about me?” Probably all of us. That’s a very natural question.

Yet, if the relationship is going to work properly, one of the first things that one must accept is that the behavior of the person with BPD is not about you.

What New Harbinger did with this new version of SWOE is that they highlighted the “angry non” aspect of the book. How? Look at the following images from the new version of SWOE:

As you can see, New Harbinger highlights the aspects of:

• manipulation
• irrational rages
• that YOU are not crazy
• chaos
• standing up for yourself
• protecting yourself

…which again is all very well and good if your goal in the relationship is to punish the other person and to make them behave. What really happens though is that the relationship will come to a screeching halt (or just get worse and worse) if you take this approach.

I know this because I tried it, as did several other husbands of wives with BPD and found (almost universally) that things get better for a while. SWOE CAN modify the BP’s behavior, but only through threats and punishment (which SWOE calls “boundaries”). Threats and punishment WORK, but only for a short period of time. When I applied the things in SWOE to my relationship, things got better for about a month or so. Then things got decidedly worse. The reason is that my wife was responding initially to the threat of punishment. However, those threats did not change her feelings or thoughts in any way. Only through positive reinforcement did she start to behave better. SWOE doesn’t teach positive reinforcement. And even positive reinforcement doesn’t change the way someone with BPD feels. That is done through a change in thinking patterns. You can take step one toward building a trusting, loving relationship with my book When Hope is Not Enough. Although the SWOE crowd don’t place much stock in it, it really works toward building a better relationship.

When Hope is Not Enough
Get the Non-BPD book that is designed for
staying and working on the relationship

Additionally, if one wants to really change the relationship and build it into a more trusting, loving one, what ultimately has to change is the way one thinks (both the person with BPD and the Non-BPD). Approaching the relationship with a “I’m not crazy, you’re the one that’s crazy” attitude, which IMO SWOE advocates, will never improve the interpersonal relationship. If you want to know how to take step two and change the thinking, try my eBook Beyond Boundaries:

New! An eBook that can help you in your relationship with someone with Borderline Personality Disorder. Beyond Boundaries is the next step in the evolution of the Non-BPD/BPD relationship.

I think one has to ask oneself – what is the goal of what I am doing? If the goal is to make yourself feel better and more in control, regardless of what the other person feels, SWOE is a good candidate for you. If you want to build a relationship built on mutual understanding and trust, you will have to look elsewhere.

If you still want to give the new version of SWOE a whirl, have at it…

Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder

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What is your goal?

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.

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Modes of Thinking

“If only”

If only is a way of thinking in which the person says to themselves “I would be happy or content, if only a certain thing occurred or if only I had a certain thing.” It is a way of objecting to the unfairness of the world. It is a form of projective, delusional thinking… Like, “if only I won the lottery I would be happy” or “if only my partner would have sex with me more, I’d be happy”… Etc. It is equivalent to asking oneself “If I could have one thing/state, I’d be ok”

“What if”

What if is different than “if only” because “what if” can be either positive or negative. What if can stimulate alternate views on the future and it can also be a substitute for “if only”. If used as an iterative testing framework, “what if” can help a person understand the possible outcome of variable changes. However, one must not assume the outcome of a “what if” – sometimes, because of the complexity of variable conditions, changing one variable could lead to unexpected outcomes.

“As if”

“As if” is an engagement of pretend mode in which some pretends as if they know something or something exists when they have no insight into the subject matter – they don’t get it – they merely bullshit their way through “as if” they get it.

“As is”

“As is” is a way of accepting reality as is and not struggling against that over which you have no control or that which you can not change. As is accepts that which is as it is and changes that which can be changed.

One piece of advice that I would provide to partners of people with BPD is that if you can’t accept the person “as is” and love them for what they are, it is most likely never going to work out in the long run. If you can’t accept them “as is” and consider any changes in the relationship or in their behavior as a bonus, then you are actually engaging in “if only” thinking.

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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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Path to Effectiveness

Over the past two days on the ATSTP Google Group, I have been happy to see some success exhibited. Many people on the Internet and on Internet email supports lists for Non-BPs will tell you that there is no hope of having a relationship with someone with BPD. Often I have seen that the only “advice” given to Nons is: RUN AWAY! Even on the “staying” sites and sub-sites, many people think that it will never get better EVER – which to me is a form of black-and-white thinking that Nons engage in.

While hope may not be enough, the BP/Non-BP partner relationship is not without hope at all. This week I received two messages from the ATSTP Google Group that gave me some hope. One was from a long-time member of the group (he’s been a member for about 2 years) and it goes like this:

I truly consider myself still part of the ATSTP community even tho I’m less deeply immersed in it now. And the reason I’m less deeply immersed now… is because I’ve learned the lessons I needed to and moved on. If this is my alma mater… consider it mission accomplished in preparing me for “college” or even the “job field” of succeeding with a BP. I arrived at grade-school level. I’m now at high-school-grad level… I recognize you, Bon, at the college-masters-instructor level. And I’m so grateful, that you have been here for me! So, thank you… keep up the spectacular work! You benefit not only your family, but so many of us out here in the world! You have made THE DIFFERENCE, in my life! I thank you profusely, and ask that you keep me ‘in the loop’ in areas which I might be able to help in or find interest in. Thanks SO MUCH, Bon! Thank you ATSTP! You’ve helped me learn and grow SO much!

It’s wonderful to hear that someone has truly benefited from the sharing, caring and skills teaching that go on at ATSTP. One success story (out of so many failures on other boards) really warms my heart.

Now as for the other message that I received – this one is from a “newbie” to the list. She joined on May 8th and has read my book “When Hope is Not Enough”. She just started applying the skills with her husband. Here’s her message:

This s#$t really works. (sorry to use that word but I wanted to express my excitement!) I used some validating words (the ones I could remember at the moment) and helped my husband calm down twice this weekend. I liked the results and am looking forward to finishing “When Hope is Not Enough”

So, here we have on person that is near the end of the path toward effectiveness and one that is at the very beginning. I’m just gratified that the methods that are provided in “When Hope is Not Enough,” on this blog and, most importantly, in the ATSTP Group are actually helping people get a handle on their relationship with their loved one with BPD.

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“When Hope is Not Enough” is 185 pages and packed with examples, conversations and frequently asked questions about BPD. “But I Love You” is only 50 pages and represents a distilling and reorganization of the material presented in “When Hope is Not Enough”. Basically, what happened was that one of my list members (of the ATSTP Google list) found that my first book was frustrating her. She has an adult daughter with BPD and found that she and her husband found the way in which I present a model of BPD in “When Hope…” was frustrating. The reason is that they wanted to know immediately about the behavior associated with BPD (such as lying, manipulation, running away, burning bridges, etc.) FIRST, rather than how I present it in “When Hope…” – where I present those symptoms LAST. I do that because I try and re-frame the Non’s understanding of BPD in “When Hope…” This approach just wasn’t working for the member of my list.

She decided to reorganize and summarize my work in “When Hope…” and did so without my prompting. She did so to help herself and her husband understand their adult daughter’s behaviors. So, she sent me a copy of her work and I edited it for accuracy, reformatted it and added some additional material that I didn’t put into “When Hope…”

The book is such a slim one (like I said 50 pages), that I don’t plan on selling it through Amazon or any other such retailer. Instead you can get either an electronic copy (for $4.00) or a printed copy ($9.95) from Lulu, which is who I use to self-publish my material. Soon, I will set up a google checkout for an electronic copy of this book, like I have with “When Hope is Not Enough” but first things first.

If you haven’t read “When Hope is Not Enough” and want a primer/orientation to how you can make your life calmer and easier with someone with BPD. You can try “But I Love You: a Primer for understanding a loved one with Borderline Personality Disorder” – and yes, it probably has a few typos, sorry. And yes, I’m sharing profits with the member.

But I Love You

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Now I have some time to answer these questions and the ones you ask in a later post. Let me start with these.

I disagree with that. I think that if your show appreciation for a commitment to change behavior that makes a BP think that they are being thoughtful and appreciative/appreciated. A person with BPD LIKES (desperately sometimes) to be liked, apprecaited and wanted. If you can navigate that tool without judgment, I suspect your wife will feel relieved that it wasn’t a dreadful statement of “thou shalt” from you to her. Also, I think “negative consequences” is not reinforcement – it is the threat of punishment. There is an implied positive consquence that you will feel better and thus treat her better – when someone is angry and frustrated they are unlikely to treat another person very well. The problem with real reinforcement at that moment is that reinforcement must occur when the desired behavior is performed (as I say in the reinforcement section) and your wife is not performing the behavior, just committing to perform it in the future.

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• Tolerance – the sensitivity to being triggered
• Uptick speed – how quickly someone gets to maximum emotional intensity
• Intensity – how “high” and intense the emotion goes
• Length of time at maximum intensity – how long one can maintain maximum intensity
• Down hill speed – how quickly the emotion peters out

I have to think more about this idea and maybe more will come. Unfortunately, Ekman’s work on this will not be published until later this year.

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At the same time, I have a problem with this book. While it is MUCH better than “Stop Walking on Eggshells” (SWOE), her previous book about NON-BPs, I agree with her prescription about 40%. Her sections on “Communicating to be heard” and “Reinforcing right behavior” are agreeable, the rest is NOT agreeable to me. I will soon offer a true book review of this new book; however, I believe (humbly) that my book WHINE is a MUCH better book for understanding and dealing with a person with BPD than either SWOE or “The Essential Guide…” by Randi. While I know where she is coming from, she misses an essential thing about BPD – that thing is IAAHF (“it’s all about his/her feelings”), a concept in WHINE. She still seems to think that you can make it (at first) about YOUR feelings, which, with BPD, is impossible at first. This is both my opinion and the opinions of the members of my group. I am a bit miffed that  SWOE sold something like 300,00 copies and WHINE 300, because I think (as do my almost 400) group members that WHINE is a MUCH better book to understand the BPD/NON-BPD dynamic than either SWOE or “The Essential Family Guide…”

I know that Randi will see this via her Google alerts and I welcome her comments. I have no argument or disagreement with Randi. I respect her and feel she is contributing to the community the best she can. At that same time, I feel her publishing efforts fall short of what is effective in the NON-BP area.

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Learned Helplessness and PTSD

Another concept that is new to this edition is the idea of learned helplessness and PTSD as Non-BP’s. Personally, I think this concept applies to both people with BPD and those who loved them. Not so long ago I was reading a “Non-BPD Staying” book (one that, as this book does, encourages the acquisition of certain skills to live with a BP). This book mentioned the idea of “Stockholm Syndrome” sometimes occurs within the Non-BP’s mind. Stockholm Syndrome is a condition in which a person who is abducted begins to feel sympathy for and identify with his or her abductor(s). It was coined following a six-day hostage crisis in 1973 in Stockholm, Sweden in which the captors began to feel emotionally attached to their abductors. This other “Non-BP” book likens the state of the mind of a Non-BP to those captors; that is, the abused person (the Non-BP) begins to develop an emotional attachment to the BP because of this dynamic. Stockholm Syndrome has also been used in the context of a weaker abused person (such as a child) bonding to a more powerful abuser. While it is not a professionally recognized diagnosis, several high-profile abduction and abuse cases have mentioned the syndrome in the popular press, including the high-profile case of Patty Hearst. I believe that application of Stockholm Syndrome to a BPD/Non-BP relationship is inaccurate in almost every case. While there may be certain cases in which this dynamic exists, of all of the individuals that I have met in person and online, I have yet to see any that could be properly described as Stockholm Syndrome.

One problem in my mind with the application of this label is that it creates a defined abuser/abused polar relationship and discounts the real affection one may have for the (supposed) love one in your life. Mistreatment certainly goes both way in any relationship and in the case of a BP/Non-BP relationship, that mistreatment can arise to the level of abuse. I don’t, however, think it can arise to the level of abductor, captor or terrorist on either part. It may feel that way at times, but relationships go through many changes during the course of months and years and to say that the overriding factor contributing to the relationship is only and solely one of abuse and mistreatment, that would indicate (to me at least) that the relationship is not based on love and one which might likely be better off terminated. However, if you are this person’s parent or child, it may not be possible to terminate such as relationship. Instead, you have to find ways to break the cycle of abuse. It is difficult, no doubt. Stockholm Syndrome is, in my mind, an extreme form of co-dependency.

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A more useful concept is that of learned helplessness. One of the major differences between Stockholm Syndrome and learned helplessness is that the former is psychodynamic or psychoanalytic (through attachment and/or object relationship explanations) and the later is behavioral. Before I began to research BPD and the “plight” of the Non-BP, I was never much of a behaviorist. Once I started to understand what actually worked with BPD, I have warmed up to the idea of behavioral therapies in general and to DBT specifically (because it is something of a hybrid approach to acceptance and change, whereas CBT is typical places more emphasis on change). There are several differences between the idea of learned helplessness and Stockholm Syndrome. First, I need to define learned helplessness such that you understand the concept and why it may apply to you (or your BP loved one).

Learned helplessness is a state in which a person (or an animal, which is a major difference because it operates at a lower brain level than does the psychoanalytic-derived object relations model that explains Stockholm Syndrome) discovers that no behavior can counteract the pain and suffering that that person is feeling. Here is a quote from the Wikipedia entry on learned helplessness:

Learned helplessness is a psychological condition in which a human being or an animal has learned to act or behave helpless in a particular situation, even when it has the power to change its unpleasant or even harmful circumstance. Learned helplessness theory is the view that clinical depression and related mental illnesses result from a perceived absence of control over the outcome of a situation (Seligman, 1975).

The idea of learned helplessness is derived from a behavioral experiment in by Seligman and Maier in 1967. These researchers took dogs and placed them in experimental conditions in which one group of dogs could stop shocks coming from a grid beneath their feet by pressing a lever. In other words, pressing the lever was the behavior that allowed them to escape pain. These dogs learned to press the level repeatedly to escape the suffering induced by the electric shocks. Another group of dogs also had the grid and the lever, but in their case pressing the lever did nothing to alleviate the painful shocks. The shocks did not increase or decrease by behaving in any particular fashion. The lever did nothing to stop the pain they were feeling. These dogs learned that they were completely helpless to lessen their pain. Eventually, these dogs merely “laid down on the gird” and accepted the shocks without attempting a behavior which might remove the shocks. This reaction is the essence of learned helplessness. If a person learns that no matter what they try nothing works to alleviate their pain, they eventually give up on trying and “lay down on the grid.”

I believe this idea better describes the dynamic between any other person (including the BP/Non-BP relationship) than does Stockholm Syndrome. I say this because unlike Stockholm Syndrome in which one party is deemed the abuser and the other the abused, learned helplessness is about pain avoidance – either on the BP or Non-BP side. If what you try, over and over, doesn’t work to alleviate pain, then you eventually learn that the pain is unavoidable and you “lie down on the grid” and accept the pain as unavoidable – or you go nuclear and terminate the relationship or commit suicide. If everything you do, even if you try the diametrically opposed action to the previous action and that doesn’t work, results in suffering and equal pain, eventually you are going to learn that you are helpless to the pain – this is what learned helplessness is all about. I don’t think this concept is only about the Non-BP (which the idea of Stockholm Syndrome assumes – that is, there is one abuser and one abused, which in a loving relationship seem ridiculous to me. I mean, after all, we are talking about “loved ones” and families are we not?), No, the idea of learned helplessness cuts both ways because both parties are using ineffective methods to remove pain and both parties end up banging their head up against to wall of ineffectiveness. If nothing works, despair rules and the only solution is to accept your fate and “lay down on the grid.”

The way out of learned helplessness is a reconditioning of one’s behavior in which the pain can be removed. That is another difference in the idea of Stockholm Syndrome and learned helplessness. The mechanics of Stockholm Syndrome are impossible to counteract (I suppose it’s years of psychoanalytic therapy or other ideas that this “Non-BP” book purports), while the mechanics of learned helplessness are difficult, yet possible, to counteract. What one has to do to counteract the condition of learned helplessness is find a behavior or technique that is not helpless. One has to find a technique or behavior that one can practice and be effective to alleviate the suffering of the condition in which one is currently helpless.

The reason that I included this section on learned helplessness in this section of the book is two-fold. While I have yet to talk about the tools to counteract this and other relationship issues that can arise from an ineffective BP/Non-BP relationship (I do that later in the book), I just wrote about conditioned behavior and I am about to write about emotional memory. Conditioned behavior and learned helplessness can happen in both humans and in animals. These two concepts are interrelated. I’m not sure about emotional memory and if it applies to animals. However, if whatever you try to reduce your pain doesn’t work, you eventually learn that nothing works – that is the state of learned helplessness. Within the framework of the BPD dynamic, if you find that your reactions and behaviors are ineffectual, these reactions and behaviors are ineffective at reducing your suffering and at fostering a calmer relationship. So, learned helplessness is related to conditioned behavior and learned helplessness can grow out of the BPD dynamic if you continue to perpetuate ineffective behavior.

Unlike Stockholm Syndrome, learned helplessness is born out of trust. Stockholm Syndrome is born out of abuse and/or hostage-taking. Your loved one is not (however it may feel at times) a kidnapper, terrorist or, intentionally, an abuser. They (and you) are trying to get needs met. The relationship generally is born out of trust and presumed love, whether romantic, familiar or friendly (or a combination of each). The basic premise of the nature of the relationship is a significant difference between Stockholm Syndrome and learned helplessness. It is not just the nature of the concepts academically (one is psychodynamic, the other behavioral), it is the foundation for the relationship that is divergent. The dogs in the learned helplessness experiments essentially trusted and relied upon their “owners” – they needed food and shelter provide by the experimenters (which in a way makes their case more tragic). In the case of Stockholm Syndrome, the initial state between subject and object is adversarial. The abusers or abductors are part of the initial part in the equation, as are the abused and the abducted. There is a clear perpetuator and a clear victim, but in my mind, no such clear lines between these categories exist in a BPD/Non-BP relationship. Certainly, Non-BP’s do feel embattled and, at times, overwhelmed, but, upon reflection, so do BP’s. Both groups are behaving in ways that are ineffective and ineffectual for reducing pain, for increasing understanding and for maintaining calm in the relationship.

One of the keys to understanding learned helplessness is to understand that no effective behavior can be found to escape pain. While BP’s might resort to “extreme” behavior to reduce their pain (such as cutting, risk-taking behavior, drug taking and others) Non-BP’s may be less likely to do so. I say “may be” less likely because I suspect that alcoholism and other such behavioral adaptations might be more prevalent in Non-BP’s than in the general population because these are behavioral adaptations that act on the pain directly, yet these adaptations are ineffective and may create other interpersonal and personal consequences. It is possible that (as in the dogs) there is no behavioral adaptation that has any effective impact on the suffering. You feel stuck and there’s no way out. That, in effect, requires that you “lie down on the grid” and accept your punishment. The trust and presumed love you felt in the beginning of the relationship is exposed as ineffective, and you feel trapped in pain. I think this is a mild form of PTSD. The point is, if you can’t do anything to get you out of pain, you’re stuck, helpless and hopeless. I called this book When Hope is Not Enough for a reason, and here’s where my intentions become clear: you can’t hope for a better and more effective solution when everything you have tried thus far doesn’t relieve the suffering and pain you feel. You stop pressing or depressing any lever because neither state relieves the pain; thus, you’re stuck in pain and suffering. However, unlike Stockholm Syndrome, I can offer you a way out of learned helplessness. The way out is through the application of tools that you can apply to the BPD dynamic that can break you out of hopelessness. And unlike psychodynamic explanations, which can take years, this escape window can take much less time. All one has to do is dedicate oneself and practice.

This form of PTSD or learned helplessness hurts and feels as if you are trapped in a cage of conditioned behavior. Yet, if you learn and apply the tools in this book, you can change the BPD dynamic and take your life back. My point is to try and introduce a new dynamic in which you can open the escape window. I have seen in this work in my life and, possibly more importantly, in the lives of the people on my list. There’s hope, but real hope only comes through the application of skills that can escape learned helplessness and PTSD forever.

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1. Bellman’s Syndrome – BPD and Chronic Pain
2. What is your goal for your relationship?
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Your book in all honesty, out of close to $400 worth of BPD materials I bought, gave me something really concrete to work with. Whether or not it works is up to many factors but, I feel confident that I have the tools I need to work off of, and that is something not even my therapist has given me no matter how much I asked.

Now, I’m no therapist. No, I’m just a regular non-BP husband and father. However, I have gotten a very strong, positive reaction to the tool and strategies that I present in WHINE. If you’re at the end of your rope or want to learn to be more effective with your loved one with BPD, please try WHINE. It has helped many in my ATSTP Google Group get a handle on their relationship. As far as I know, it is the only “lay person staying” book out there. Most of the other non-BP books are written by ex-husbands (e.g. Tears and Healing, Siren’s Son, One Way Ticket to Kansas) and deal with the non’s emotional recovery from the BPD relationship. WHINE deals with how you can effectively interact and communicate with someone with this difficult and, at times, chaotic disorder. If you are a spouse that wants to stay or a parent that has to stay, I would recommend WHINE.

You can purchase WHINE at Amazon or Barnes and Noble.com. You can also buy an electronic copy for only $7.50 from the publisher.

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Celebrities with a PD rose to 53% of the traffic – it’s amazing what people are interested in.

BPD General rose to 26% of my traffic. This is due in part to my running a Google AdWords campaign on the term “BPD” to try and get my book, When Hope is Not Enough: a how-to guide for living with and loving someone with Borderline Personality Disorder, into the hands of more people.

Coping was about the same as in the past.

I was happy to see that “BPD evil” and “BPD demonic possession” has dropped off the top search terms.

Now for some notable recent search engine terms that found my blog (my comments in parenthesis):

bpd blame (yes, they do a lot of it)
bpd sluts (hmmm…)
why are borderlines evil (they’re not)
i’m in love with bpd woman (fasten your seatbelt!)
“npd”+”marriage” (no, please don’t)
bpd people why they threaten to leave you (because they want to leave you before you leave them)
inner child borderline personality disorder (not the inner child again, please!)
bpd family guilt no contact (that’s tough)
demonic symptoms (it doesn’t exist)
suicide how to do it (I almost cried at that one)
dbt parenting skills (read WHINE and take a DBT-FST class)
how to calm someone who is dysregulated (read WHINE)
praying for spouse with bpd (sometimes hope is not enough)
bpd and bitch (ouch!)
how to tell someone they have bpd (don’t)
demon possession vs. mental illness (these people and their beliefs in demons)
borderline personality girl causes trouble (I bet!)
bpd don’t know how to show love (no, they have too much shame until they are treated)
loving a bpd (it’s a rough road)
borderline personality god (I guess they were looking for answers, not diagnosing god)
tough love therapy (it doesn’t work with BPD)
do people with bpd cheat more (some of them do)
do people with bpd ever realize the truth (emotional truth, yes)
bpd body image (it ain’t good)
demon possession borderline personality (the demons AGAIN?)
how to get rid of bpd spouse? (I hope you didn’t mean “get rid of” like really get rid of)
child of a borderline hell (that’s sad)
i want bpd ex back (you sure?)
“bpd” burn bridges  (yes!)

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When stress and anxiety are high, the R (reptilian) system is exaggerated.  In other words, people become more thoughtless, more instinctive, and more automatic.  The same is true concerning the feeling brain.  Once fueled by limbic-derived feelings, we have less access to the thinking brain.  Both brains have ensured the survival of the individual and the species.  Necessary to survival, feelings have an insistent quality and are hardwired into the nervous system.  With strong arousal, the limbic brain can be driven to continue.  The reactive force can go on for hours.  Highly excited emotional states are like poison ivy – we become all itch.

The point of this quote is to illustrate that emotions operate at a lower level in the brain than do values and even thoughts. The author goes on to say:

One of the functions of the thinking brain is to exercise veto power over the instinctive forces of the two lower brains [Reptilian and Feeling brain].  It sets limits on behavior; it provides self-control.  This is one reason moral codes are stated in the negative – “Thou shalt not . . .”  Nonetheless the lower brains, more automatic and defensive than the thinking brain, have a quicker triggering effect and do not easily defer to the thinking brain.

The phrase “do not easily defer to the thinking brain” is an understatement in my opinion. If someone is overcome with emotions, especially strong, negative emotions which is the likely situation with BPD, the “lower brains” at which the emotions are operating will rarely defer to the thinking brain. Therefore, if a person with BPD acts in a way that goes against his/her values, that is probably the cause.

A detailed explanation is available in When Hope is Not Enough:

See larger image When Hope is Not Enough (Paperback) By (author) Bon Dobbs List Price: $19.95 USD New From: $18.21 In Stock Used from: $17.30 In Stock

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I have read the book and it amazes me how so much valuable information can be condensed into such a quick and easy read. It is written in a style that most anyone can understand and it is filled with useful examples on how to use this approach in everyday situations we all face with highly emotional people. Used correctly, the information provided in this book can help you improve your relationship right now… not next year, not next month, TODAY.

On my free email support list for Non-BPs (the ATSTP Google Groups List), a member said this about the downloadable version of WHINE:

It didn’t take me long to figure out that for me, faster progress will be made from
reading Bon’s book WHINE.  I bought the electronic version for $7.50, printed
it out and put it in a little 3-ring binder.  I have now read it once and have
started the second time through after a couple of days letting it sink in.  I had
the pleasure of experiencing one of my BPDW’s “storms” during this sink-in time.
She was the same – I was different.  Kinda surreal experience.

The printed version has a retail price of $19.95, although it is being sold by Amazon and Barnes and Noble for $17.95. If you buy the eBook version you can get the same content for only $7.50.

Buy the eBook version of WHINE here.

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http://www.amazon.ca/When-Hope-Not-Enough-Dobbs/dp/1435719190/

BTW, it has been available in the UK for a while now:

http://www.amazon.co.uk/When-Hope-Not-Enough-Dobbs/dp/1435719190/

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Rainbow for Hope

In Oct 2007, I was at my wits end and ready to walk away from my raging husband after 4 months of marriage. He had been in therapy for over a year, yet still raging almost daily, beating himself half to death, lying to me about the most ridiculous stuff and destroying our home. All this chaos was causing my 2 teenagers to alienate me out of fear of him. As a Project Manager, I had participated in many classes and seminars on effective communication in the workplace through my job, but it seemed that nothing I tried worked with my husband… most of the time, it only seemed to make things worse. I truly felt helpless. I knew I loved him and I fully understood the complexity of this disorder and how my own (natural) reactions to his behavior contributed to the dynamics of our relationship, but I also realized I didn’t have what it took to provide the healthy and supportive home environment I knew he needed in order to heal from his past.

At the urging of my own therapist (whom I had retained for my own sanity), I decided to join an online support group for loved ones of people who suffered from Borderline Personality Disorder. I found a group called Anything To Stop The Pain (ATSTP). As time went by (with me lurking in the group), I realized that the founder of the group (Ben Dobbs, the author of this book) was promoting a very similar approach with group members that my husband’s therapist was using with him during their sessions. I got more involved with the group and learned how to use this approach, at home, with my husband (and, consequently, with other family members also.)

Ten months later, I’m happy to say that my husband’s raging has reduced to, maybe, once every few months and the intensity is nothing like before — despite the fact that he hasn’t been attending therapy on as regular a basis as I had understood was necessary for improving his emotional health. We are finally enjoying the closeness we both wanted in our marriage. My house feels and looks like a home again (rather than a battlefield) and my kids are back to spending more time with us again. He is slowly changing his maladaptive coping methods to more healthy ones… and working out his past by using this same approach with his own family. It feels good to get genuine apologies (versus “FINE! IT’S ALL MY FAULT!!”) and ‘thank you’s’ (versus daily blaming and projecting) for my patience and understanding.

I have read many books on this disorder. I found ‘Stop Walking on Eggshells’ to be quite validating to my feelings as a loved one (a NON) to a borderline. In that sense, it was very healing for me, personally, but it didn’t help me improve my relationship. ‘I Hate You, Don’t Leave Me’, ‘Sometimes I Act Crazy’ and ‘Get Me Out of Here’ were beneficial to me in that they helped remind me that my husband’s erratic behaviors really were not about me at all. From my personal experience, this book is the next progressive step for those who recognize that they cannot FIX their borderline loved one, yet still have a smidgen of hope that there is a way to find peace and harmony with this person IN their life.

I have read the book and it amazes me how so much valuable information can be condensed into such a quick and easy read. It is written in a style that most anyone can understand and it is filled with useful examples on how to use this approach in everyday situations we all face with highly emotional people. Used correctly, the information provided in this book can help you improve your relationship right now… not next year, not next month, TODAY.

I highly recommend it for anyone who truly wants to learn how to effectively communicate with someone (spouse, parent, child, friend, co-worker or boss) who is struggling with an emotional regulation disorder. You don’t have to give up your rights or go without getting your needs met anymore to stay in this relationship! And the nice thing is, it doesn’t require therapy or counseling to be successful. All you need is an open mind and a desire to try something different… something that works!

WHINE (When Hope is Not Enough) is available at Amazon and other Internet retailers.

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I decided to write this post because I have seen many non-BPs frustrated over the fact that when they try to use the tools in certain books with their BP, the tools seem to cause more rage and emotional dysregulation. The two “tools” that I have found that cause the most problems are boundaries and detachment. I’ve already written a LOT about boundaries and where my view of boundaries diverges with some of the other “Non-BP authors.” Today, I’d like to turn to detachment.

“Stop Walking on Eggshells” recommends on page 98, that a Non-BP “detach with love” from a BP and BPD-like behavior. This concept was “borrowed” from Al-Anon as it is made clear in SWOE. I think that “detaching” (whether with or without love) works in some situations and blows up in the Non’s face in others.

What are the differences? In WHINE, I explain that the “engine” of BPD is emotional dysregulation (which is the opposite of regulation). A person with BPD will heat up more quickly and cool down more slowly than someone without the characteristic of emotional dysregulation. One study that I cite in WHINE deals with “neutral” reactions to someone who is dysregulated. The basic evolution of an (as “Tides” calls it on her blog) Emotionally Dysregulated Moment (or EDM) is trigger -> cognition -> emotion -> expression -> behavior. Emotions can spur on other emotions. Anger is IMO the most powerful of the basic emotions and it is easily triggered, especially when a person with BPD is feeling judged. Ok, now back to detachment. On page 39 of WHINE, I explain that:

One of the most interesting findings of a study in which scientists used functional magnetic resonance imagining (fMRI) to measure the emotional reaction (limbic system activation) of patients with BPD is that these people react to neutral faces in the same manner they react to angry faces. In essence, when shown a picture of a person with a neutral expression, people with BPD showed amygdala activation as if the picture was one of a person with an angry expression. These people expect judgment and anger in others towards them and react physically and mentally to neutral situations as if they are threatening. They are likely to find “meaning” that is judgmental or threatening in an event that others would see as meaningless. A member of my list compared this reactivity to neutral faces to neutral feedback on eBay. As a buyer on eBay, you don’t give neutral feedback to a seller when everything about the sale is perfect. You give [neutral] feedback when something is wrong. A person with BPD will interpret a neutral face as “something wrong.”

Emotional detachment from an EDM will trigger more emotional dysregulation within a person with BPD. Instead, an EDM is a time to engage someone with BPD and engage them on an emotional level. Otherwise, if you detach emotionally from the situation, the BP will interpret your “calmness” and detachment as judgment or criticism. Additionally, they will likely consider you untrustworthy to validate their emotional states. What I mean by this is that if they are feeling so much emotional pain that they are dysregulated what they are really trying to do (regardless of the content what they say) is to communicate that pain to you. If they’re “dying in pain” and you’re detaching and calm, they feel they can’t come to you with the problem. On page 95-96 of WHINE, I describe this situation as follows:

The purpose of someone coming to you in an emotionally dysregulated (or close to one) state is to communicate the emotions that she feels. She may have difficulty expressing these emotions and may use other means for expressing them such as blame, sobbing, cutting, raging or other behaviors that are difficult for you to deal with. The underlying point however is one of communication – she is trying to tell you something, but she doesn’t have the language for it. Therefore, if you respond to an emotional communication in either an invalidating fashion (using one of the many, many invalidating phrases above) or in a way that doesn’t match the emotional distress, the BP will feel unable to communicate. She will think “I’m going off the deep end here and you are so calm! You don’t understand anything! You’ll never understand me!”, and not trust you. The tenor of your voice is more effective if you express your emotional identification with emotion in your voice as well, but with slightly less emotion than the BP is feeling. In other words, express distress in the identification, but less emotion than if you are actually in distress yourself.

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