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When Hope is Not Enough, Second Edition: A how-to guide for living with and loving someone with Borderline Personality Disorder
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Dialectical Behaviour Therapy (DBT) and the Buddhist Philosophy

DBT deals with intense and labile emotions. There is a connection between mindfulness and emotion regulation. Mindfulness facilitates adaptive emotion regulation.

Dialectical Behaviour Therapy (DBT) and the Buddhist Philosophy

Posted on March 20th, 2017
Ruwan M Jayatunge M.D.

Dialectical behavior therapy (DBT) is a modified form of cognitive behavioral therapy (CBT) that was developed in late 1970s by Marsha M. Linehan a psychology researcher at the University of Washington (Linehan, 1993). DBT is an empirically supported treatment for suicidal individuals (Linehan et al., 2015). It can be adapted to treat borderline personality disorder patients with comorbid substance-abuse disorder (Koerner & Linehan, 2000) and depressed elderly clients with personality disorders (Lynch et al., 2003). DBT addresses deficits in emotion regulation, distress tolerance and interpersonal relationship.

The patients with borderline personality disorder have faulty schemas and splitting in the patient’s relations to others. They have frantic efforts to avoid real or imagined abandonment. Often they have pattern of unstable and intense interpersonal relationships, impulsivity, emotional instability and recurrent suicidal behavior. In addition they are impacted by chronic feelings of emptiness. Borderline personality disorder is treated with psychotherapy and medication. Dialectical Behavior Therapy and Buddhist Psychotherapy are effective in treating borderline personality disorder.

The basis for DBT is stemming from the mindfulness practice of the Buddhist teachings and the philosophy of dialectics. Mindfulness according to the Buddhism is bare attention a sort of non-judgmental, non-discursive attending to the moment-to-moment flow of consciousness (Sharf, 2015). Mindfulness meditation has three overarching purposes: knowing the mind; training the mind; and freeing the mind (Fronsdal, 2006). As described by Palmer (2002) developing the capacity for being mindful and living in the moment allows a greater potential for feeling appropriately in charge of the self.

DBT combines mindful awareness largely derived from Buddhist meditative practice. Kirmayer (2015) concluded that Mindfulness meditation and other techniques drawn from Buddhism have increasingly been integrated into forms of psycho-therapeutic intervention. Since the 1990s, mindfulness meditation has been applied to multiple mental and physical health conditions, and has received much attention in psychological research (Tang & Posner, 2013). Mindfulness has been described as a practice of learning to focus attention on moment-by moment experience with an attitude of curiosity, openness, and acceptance (Marchand, 2012) Schmidt (2004) states that mindfulness is strongly related to compassion, and it is compassion that serves as a source for all healing intentionality. Both mindfulness and self-compassion involve promoting an attitude of curiosity and non-judgment towards one’s experiences (Raab, 2014). The core mindfulness skills (focus, compassion, curiosity, inner calm, balance, and awareness) lead to serenity.


How to Get Better at Expressing Emotions

Extroverts tend to be better at talking about their feelings, but practice and attention can help those without a natural gift for it.

How to Get Better at Expressing Emotions

The term “emotional intelligence” has now reigned for 20 years. Daniel Goleman’s 1995 book of the same name popularized the idea that the capacity to understand and wield emotional information is a crucial skill.

Part of that is expressing emotions, be it through writing, body language, or talking with other people, and researchers are finding that unlatching the cage and letting those emotional birds fly free could have some real health benefits. Some studies have linked the repression of negative emotions to increased stress, and research suggests that writing about feelings is associated with better health outcomes for breast-cancer patients, people with asthma, and people who’ve experienced a traumatic event. And in a study of people who lived to be 100 years old, emotional expression was found to be a common trait, along with a positive attitude towards life, among the long-lived.

So expressing emotions, on the whole, seems to be good for you. But if you’re someone who is used to holding them in, that could be easier said than done. And the solution is not necessarily to just pop the top off that champagne bottle of emotions and watch them spray all over the place. You might not even know what’s in there!
Emotional intelligence is a skill, and some people are better at recognizing and communicating emotions than others. Among the Big Five personality traits—openness, extroversion, conscientiousness, agreeableness, and neuroticism—several studies have found that people high in extroversion tend to have higher emotional expressiveness, while people high in neuroticism tend to be less expressive.

Like other skills, the ability to communicate feelings can be strengthened through practice, and a big part of it is first recognizing the emotions you’re having, as well as what’s causing them.


The Benefits of Getting Comfortable With Uncertainty

Wanting and not wanting the same thing at the same time is a baseline condition of human consciousness.

The Benefits of Getting Comfortable With Uncertainty

Gary Noesner is a former FBI hostage negotiator. For part of the 51-day standoff outside the Branch Davidian religious compound in Waco, Texas, in 1993, he was the strategic coordinator for negotiations with the compound’s leader, David Koresh. This siege ended in infamous tragedy: The FBI launched a tear-gas attack on the compound, which burned to the ground, killing 76 people inside. But before Noesner was rotated out of his position as the siege’s head negotiator, he and his team secured the release of 35 people.

Jamie Holmes, a Future Tense Fellow at New America, spoke to Noesner for his new book Nonsense: The Power of Not Knowing. “My experience suggests,” Noesner told Holmes, “that in the overwhelming majority of these cases, people are confused and ambivalent. Part of them wants to die, part of them wants to live. Part of them wants to surrender, part of them doesn’t want to surrender.” And good negotiators, Noesner says, are “people who can dwell fairly effectively in the areas of gray, in the uncertainties and ambiguities of life.”

For most people, that’s pretty difficult. It’s natural for humans to be uncomfortable with uncertainty—if you don’t know what that dark shadow in the bushes is, there’s a good chance that it’s a threat. But beyond the caveman metaphors, there are benefits to being able to cope with ambiguity and ambivalence. Noesner thinks Koresh was of two minds about surrendering, and Holmes suggests that if the FBI had been more cognizant of that, it might not have rushed to attack the compound. He also suggests that in less strained situations, in our everyday lives, we might avoid a lot of anxiety and jumping to wrong conclusions by accepting that sometimes people do feel two ways at once. Things can be similar without being exactly the same. Some things we can never know.


The Dangers of Getting Only One Point of View

Black-and-white rigidity is actually one of many symptoms of people with borderline personality disorder.

The Dangers of Getting Only One Point of View
by David Mills

Experts say people who only seek out information that backs up their opinions may become angrier, less empathic, and unable to have meaningful relationships.

On electoral maps, Democratic states are portrayed as blue.

Republican states are represented by red.

However, it appears the ardent supporters of both parties are only willing to see things in black and white.

With the proliferation of websites, the availability of personal social media platforms, and the narrow specialization of cable television news networks, people in the United States are increasingly seeking out information that only jibes with their vision of things.

A 2014 report by the Pew Research Center concluded liberals and conservatives turn to distinctly different outlets when they want to get news and information

Conservatives flock to Fox News. Liberals go to MSNBC, NPR, or The New York Times.

Molitor says this selective information seeking isn’t limited to politics, although that tends to be the most emotional.

It can also be observed when people are taking sides on education issues such as charter schools or parenting issues such as vaccinations.

“It’s a broader issue for society,” she told Healthline.

Besides creating underinformed or even ill-informed readers, Molitor says the confirmation bias phenomenon is also producing some worrisome social trends.

She said it can erode people’s ability to be sympathetic, to be tolerant, or to utilize their critical thinking skills.

“Often times there are no simple solutions,” she said.


I Was Very, Very Afraid of the Dark

In retrospect all that paranoia was—I’ve been told—an early warning sign of my borderline personality disorder, bipolar, and severe anxiety.

I Was Very, Very Afraid of the Dark
By Patrick Marlborough

I suffered from acute night terrors and paranoia as a kid, and I still feel the after-effects today.

Night terrors, aka pavor nocturnus, is one of two non-Rapid Eye Movement sleep arousal disorders in the DSM-5. It’s a lot like sleep paralysis, but instead of being stuck in a sort of limbo waking state, you’re frozen by sheer terror. They often come accompanied by screaming and panic attacks.

I always had a hyperactive imagination: no trouble conjuring up stories and bullshit. And sure, most kids suffer from nightmares and hallucinations; but mine were abnormal —debilitating—and lasted well into my teens.

The main problem was the way my sense of horror and paranoia bled into my awake hours as well. I remember once in 1999, my parents have left me home alone for two hours to attend an Australian Labor Party branch meeting. When they left, I was sitting in front of the TV playing Lylat Wars on 64, telling myself I was fine.

But as soon as that front door close, I ran around the house switching on all the lights and barricading the doors. I barred the entrance to the living room with a sofa. My parents—once big in the world of indigenous education and worker’s rights—had a large collection of aboriginal weaponry from their years up north. I set about arming myself: boomerangs, clubs, a throwing spear.

My great-grandfather had come back from the Bore War with a quiver of poison-tipped arrows and a bow, so I slung it over my back, put myself in a brightly lit corner, and waited.

I was certain that murderers were out to get me. I was certain that ghosts were waiting for me to fall asleep so they could snatch me out from my bedroom window. But of course, nothing happened and I just stood around heavily armed for hours.

I grew up in Fremantle, and people were fond of saying that it was “the most haunted town in the world.” That didn’t help. Plus our house was convict built; a duplex, only half of it got sun. It creaked and shuddered while atmospherically throwing up strange shadows and tricks of light. You could hear my neighbours stomping down their hallway, but it sounded as though they were walking past my room.


Refusing to be defined by borderline personality disorder

The condition goes hand in hand with depression and anxiety.

East Maitland’s Victoria Campbell refuses to be defined by borderline personality disorder
by Sage Swinton

For Victoria Campbell, the past two years have been an emotional rollercoaster.

The East Maitland woman has faced a daily battle against borderline personality disorder (BPD) since her diagnosis in 2014.

She has struggled to manage her emotions, suffered deep depression and displayed extreme reactions that she could not control.

“You don’t know whether you’re overreacting,” she said.

“You worry about every contact with every person. You think you’re an idiot, you’re a fool.”

The condition goes hand in hand with depression and anxiety.

“The anxiety stops me from going out. I struggled to do the grocery shopping,” Ms Campbell said.

The downs left Ms Campbell in hospital for up to two months at a time.

But out of that negative came a positive – art.

“When I was in hospital I did a few sketches,” she said.

“To be able to draw or write down those feelings helps to get those emotions out when you can’t find the words.”

Her works were displayed at a pop-up show on Tuesday, which Ms Campbell said helped break the stigma about mental illness.

“People misunderstand or misconstrue BPD,” she said. “To be able to present that puts a real face and a real depth of feeling behind it.”