Borderline Personality Disorder,  DBT,  Validation,  WHINE Book

WHINE and DBT Skills Compared

Occasionally, a discussion on my private email list that I feel it would be helpful to share here. I only do it if the discussion is not personal in nature. This discussion is about proper application of the skills in WHINE and how they compare to DBT skills. My list member’s question/comments are indented… my responses are not.

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

Thanks again Bon.  Now I am re-examining how best to communicate.  I
have a bunch of things I have been thinking about WHINE that I wanted
to ask you about:

WHINE is not perfect. It was my best effort at the time and continues to evolve. But I think I put in WHINE what was most effective for ME, as opposed to using DBT skills by rote. I had to adapt them beyond what I learned in DBT-FST class.

– You describe a modification of DEAR (using different words) as a
tool for the non.  Do you just see the rest of the acronym as not as
relevant for the non?

That’s a good question. Actually, I think the MAN part of the skill IS applicable to the non. Although it is intended to be a skill for BPs to use to have an effective conversation and ask for what they want. I believe the DEAR is the WHAT to do and the MAN is the HOW to do it.

M – mindfully (ignore distractions and stay on subject)
A – appear confident
N – negotiate

However, in the case of the non, I adapted the tool to make it about the non’s feelings, rather than about asking for what you want. What you are asking for in my version is for a behavior change that would improve your feelings. I think that what nons have to do is become more aware of emotions – both theirs and their BP’s – and become less dependent on rational argument. If you talk about desires in the communication, you might be likely to lean on rational arguments. I tried to craft the tool such that it would “meet in the middle” with a BP. You see, when you start such a conversation, your wife will immediately start to feel judged. She will fear that you are creating “boundaries” (really behavioral rules) for her and that HURTS her. If you make it about your feelings more so than her behavior, then she can’t argue with you – see below for more on that. She also finds that the conversation will not hurt as much. When you talk to her about something “important to you” she’s going to feel dread that you’re going to judge, reject and shame her.

– You discuss these modified DEAR tools in your “Inserting your
feelings” section, which is separate from your discussion of
“examining the consequences” and “facilitating problem-solving” (which
you include as parts of validation).  But I think each of these are
useful for communicating to a BPD beyond validation and attempting to
elicit behavior that you would prefer to see.

The examining the consequences and facilitating problem-solving is to encourage more effective future behavior in her. You do that when ineffective behavior has arisen as a result of an EDM. It should be done in a GIVE kind of way. “Gentle, Interested, Validating, Easy Manner”. That is the HOW. What I have provided is the WHAT to do. Inserting your feelings is a way of soliciting some sympathy/empathy from your BP – it is about YOU. The complex validation technique (steps 1-6) are about HER – IAAHF. Inserting your feelings is a way to make it IAABOYF (it’s all about both of your feelings). I think one must build trust with validation and, if possible, facilitate effective behavior in HER. Both skills are important, but they have different goals. Obviously, they can be used in conjunction (and I put a conversation in WHINE in which both skills are used).

– Also, the I-AM-MAD tool seems to be a summary of the validation
tool, and does not include the “inserting your feelings” tool (but it
does include “examining the consequences” and “facilitating problem-
solving”–am I right?

Yes, the I-AM-MAD tool is a sub-set/summary of the six step validation technique.

– You say that if we state “I feel ____”, then there is nothing for
the BP to argue with because this is a non-judgmental statement.  But
my wife consistently tells people what they should and should not
feel.  And I really expect that she’ll feel judged by this because she
thinks in terms of blame–she’ll assume I mean that it is her fault
that I feel that way.  Of course I can clarify, but my point is that I
will probably *have* to clarify.

Clarify by using normalization statements about your own feelings. I do state that you can’t be argued with and I still believe it. If I say “I feel angry” the only thing that can be argued with or thought to be judgmental is WHY I feel angry – the fact that I DO feel angry can’t be argued with – it is a statement of an internal feeling. She might expect blame and judgment – but that is why I broke the tool up into the different steps. People with BPD understand emotions. She will know how it feels to feel angry, sad, frustrated, scared, etc. Talking to a person with BPD on an emotional level is one that they will instinctively understand. One has to be careful not to have “weasel words” in your statements that indicate judgment. Even better is if you don’t actually judge the person at all, just state what happened. The “inserting your feelings” tool is like a reverse of the validation tool. It is to work on your feelings, not theirs.

– DEAR includes reinforcement–we can say that if they do change or
adopt the behavior, then there will be benefits (or negative
consequences, I suppose).  But you changed reinforcement to “thank you
if they choose to do what you want” and your example says, “this will
definitely make me feel less ____.”  I don’t really understand why my
wife would be motivated to change her behavior because of how I feel.
This is the last thing on her mind.

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.

One Comment

  • invidiata22

    I really like this play on dear man…a little hard to understand but I am going to print this keep this around and try it….nice work

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.