Your Weekly Meditation: Emotions, Like People, Often Need to Be Unfolded to Be Understood

Emotions, like people, often need to be unfolded to be understood.

Sometimes a person may appear quite reserved – even unfriendly – but then over time, with trust and consistency, layer by layer gets unwrapped and that person’s true personality and warmth finally shines through. In the same way, just because an emotion may initially introduce itself to you only on one level, this doesn’t mean there aren’t other, deeper emotions at work beneath it. For instance, “anger” may in time reveal itself as “fear.” “Elation” may turn into “anxiety.” “Sadness” may make way for “peace.” Just as a friend often requires time and attention before the fullness of their personality is unfolded, so too do your own emotions often require your consistent time and attention to become fully known.

This week I resolve to: Notice the presence of initial strong emotions and take the time to greet them, sit down, have a conversation, and get to know them in their entirety.  As I do this, I also more fully meet myself.

 

Your Say Yes to Life Monday Motivator: V is for Validation, Part Two

This week we continue our series on Borderline Personality Disorder (BPD).

BPD is a brain-based emotion regulation disorder that affects an estimated 18 million Americans. Usually appearing first in early adulthood, by the time BPD is accurately diagnosed, many close relationships may already be irreparably damaged or destroyed.

In our last post, I introduced you to one of the most powerful techniques loved ones can use to facilitate improved relationships with a BPD sufferer. The technique is called Validation, and in this post I will introduce the basics of how Validation works and how to use it.

Validation works by making approval of, appreciation for, and understanding of the BPD sufferer a priority over any other message that may be conveyed. Basically, validation is a technique that softens the delivery of a message without changing its content overly much.

Using Validation challenges the loved one of a BPD sufferer to find a way to stand in their shoes, understand what their world is like, and communicate from that place of empathy and understanding. In a sense, imagining that you have the same symptoms and imagining how communications might affect you in that case paves the way for Validation to have its positive effect.

Its usefulness in managing BPD aside, Validation is a powerful technique in its own right. Whether an individual suffers from BPD or not, Validation is still an important part of any trusted connection, and loved ones can draw from their own positive experiences of receiving Validation to use the technique with a BPD loved one. The difference between a non-BPD and a BPD individual’s experience of receiving Validation is one of magnitude of the need for it, rather than the necessity of receiving it.

One Validation exercise that can be extremely helpful is what Dr. Marsha Linehan, founder of Dialectical Behavioral Therapy (DBT) and creator of DBT tools such as Validation, calls the “Validation Sandwich”.

Understanding how the Validation Sandwich works can streamline communications between a BPD sufferer and his or her loved ones.

When employing the Validation Sandwich to express preferences or feedback that have the potential to provoke an extreme reaction in someone with BPD, DBT experts guide loved ones to place validating statements before and after the potentially distressing communication.

In this way, the individual with BPD hears and takes in that they are seen, heard, known, and supported right from the start, and as a result they become more willing and able to hear out difficult communications with less fear of abandonment or rejection.

DBT-trained experts guide loved ones to become more acutely aware of areas where the BPD individual is behaving in responsible, emotionally sound, and healthy ways, and to make validating those behaviors a priority in any communication, whether light or more serious. Validation is not meant to sugar-coat the acting out of the symptoms of BPD, but rather to reinforce the visible signs of recovery progress.

Validation lets the BPD sufferer know that their efforts are noticed and applauded, and that there is genuine care and affection for the person, even if there is less tolerance for the behaviors as they occur. In this way, slowly but surely, the balance shifts to create a more trusting, stable foundation for future communications to occur.

Another popular Validation technique is known by its acronym – GIVE. GIVE stands for Gentle, Interested, Validating, and Easy in manner. Practicing GIVE reigns in a loved one’s propensity towards fighting fire with fire (by reacting in kind to a BPD-based outburst) and instead teaches a more effective way of fighting fire – with cooling, calming water. With GIVE, attacks or outbursts are met with gentleness and an even demeanor, with empathy and understanding, with the ability to sift the wheat from the chaff in behavioral expression, and with an easefulness that comes from sincerely believing that BPD is a treatable disorder and that the BPD sufferer has what it takes to recover.

GIVE, like other Validation techniques, is very affirming and reassuring to the individual with BPD, and has an equal effect on loved ones when they see that Validation truly does open up new lines of communication in previously strained relationships.

If you or someone you care about is suffering from symptoms that appear to be related to Borderline Personality Disorder, don’t wait! Seek help right away as BPD can be life threatening. At Southlake Counseling, our staff has received extensive training from DBT Founder Dr. Linehan’s Behavioral Tech Institute. We have more than two decades of experience successfully treating BPD through Dialectical Behavioral Therapy. We also offer supportive DBT-based skills-building groups for family, loved ones, and friends of BPD sufferers. These groups instruct loved ones in DBT techniques such as Validation and much, much more. Learn more at www.southlakecounseling.com.

Be Well,

Kimberly

 

 

Your Say Yes to Life Monday Motivator: V is for Validation, Part One

This month we continue our exploration of Borderline Personality Disorder (BPD) and its effect on BPD sufferers and their families.

As you may recall from last month’s posts, May was Borderline Personality Month. BPD is now known to be a brain-based emotion regulation disorder that often begins to arise in early adulthood and affects more women than men. The disorder manifests in a devastating emotional sensitivity that makes it difficult for some and impossible for others to maintain the type of close, nurturing, mutually supportive relationships that make life feel worth living.

This explains why, out of the 18 million Americans who have BPD, 10 percent will commit suicide before adequate diagnosis and treatment is offered. Additionally, current statistics state that 33 percent of all youth who commit suicide are found posthumously to have displayed symptoms characteristic of BPD that went undiagnosed.

In my work as Program Director with Southlake Counseling, I have seen firsthand how a lack of knowledge, lack of or improper diagnosis, and inadequate or improper care can lead to the tragic loss of a loved one who has BPD, and the unnecessary total breakdown of family systems. I say unnecessary, because there are some practical, accessible skills that loved ones of a BPD sufferer can begin to employ right now to ease the tension in their relationships and restore valued connections.

In this post, I would like to introduce one such technique: Validation.

Validation is a term that was first employed in Dialectical Behavioral Therapy (DBT), which is a therapeutic method designed by Dr. Marsha Linehan specifically to treat BPD. Validation is a DBT-based technique that is carefully designed to counteract the natural emotional response nearly every important communication has the potential to evoke in a BPD sufferer.

In the normal world of a person with BPD, their brain is not wired as sensitively to relational cues as a non-BPD individual’s brain is. So it is much easier for a BPD sufferer to feel invalidated or rejected by even a mundane or routine interaction with a loved one.

Validation is a direct counter to the BPD individual’s assumption that every communication is invalidating until proven otherwise. The rage, the suicidal actions, the emotional outbursts, the self-harming behaviors, the expressed fearfulness and the impulse control issues all stem from a feeling of being rejected, abandoned or invalidated by a person who holds an important role in the BPD individual’s life.

Learning how to successfully communicate with a loved one who has BPD is based upon understanding their inner emotional landscape and working with rather than against their BPD-influenced perception of relationships and events. Using Validation promotes that awareness and understanding, and opens up the door to better communications between the BPD sufferer and those who share their life.

In our next post, we will explore how to use Validation to facilitate communications with a BPD sufferer. So stay tuned!

If you or someone you care about is suffering from symptoms that appear to be related to Borderline Personality Disorder, don’t wait! Seek help right away as BPD can be life threatening. At Southlake Counseling, our staff has received extensive training from Dr. Linehan’s Behavioral Tech Institute. We have more than two decades of experience successfully treating BPD through Dialectical Behavioral Therapy. We also offer supportive DBT-based skills-building groups for family, loved ones, and friends of BPD sufferers. Learn more at www.southlakecounseling.com.

Be Well,

Kimberly

 

Your Say Yes to Life Monday Motivator: May is National BPD Awareness Month

This month, we recognize the power of education and awareness efforts to save lives.

In 2008, May was designated as National Borderline Personality Disorder Awareness Month by the U.S. House of Representatives. H. Res 1005, spearheaded by Representative Tom Davis (R-VA) and Representative Chris Van Hollen (D-MD), passed unanimously when put to a vote, and this year we celebrate the 4th year of ongoing awareness and education efforts by committed researchers and survivors to better serve affected individuals and their loved ones.

Borderline Personality Disorder, or BPD as it is commonly called, affects an estimated 18 million Americans. Approximately 10 percent of BPD sufferers will commit suicide before adequate treatment is provided. 33 percent of youth who commit suicide have displayed prior symptoms associated with BPD.

When BPD first begins to rear its head in early adulthood, this brain-based psychiatric illness can have devastating results. Loved ones watch, first with puzzlement and later with fear and hopelessness, as their loved one begins to exhibit the severe emotional instability that characterizes BPD.

As BPD progresses, rageful outbursts, recurrent attempts at self-harm and suicide, extreme fear of abandonment (imagined or real), impulse control issues, and severe relational chaos become the norm rather than the exception. In the wake of the interpersonal devastation BPD causes, loved ones of a BPD-affected individual often feel unable to cope.

The good news is, there are several national organizations that are now actively engaged in year-round initiatives to connect BPD-affected individuals and their loved ones with sources of hope, inspiration, treatment, and ongoing support.

The National Education Alliance for Borderline Personality Disorder (NEA-BPD) has posted information about the history of National Borderline Personality Month and ideas for how to share information about BPD in your community.

Activist Tammy Green, herself a survivor of BPD, serves as a spokesperson for the NEA-BPD and urges BPD sufferers and their families not to retreat into silence and secrecy, but to reach out, speak out, and connect with others who may be able to offer support and assistance. As Tammy states in her article “BPD 2.0 – The Next Wave”:

Onward my friends. We are in this together. And what a wonderful ride it is, if only we will allow it. There is much to celebrate, and much to do.

For survivors like Tammy, it is all too clear how critical education and awareness-building actions are for sustaining affected individuals and their families through the often deadly progression of the disease. She urges affected individuals and their loved ones to educate themselves about the disease, and then pass what they have learned on to others as well.

This month, in recognition of the powerful impact awareness and education can have in the lives of those who suffer, consider sharing information about BPD in your community. I encourage you to use the NEA-BPD literature, posted on their website, to inform others about how BPD develops and progresses, and current recommended treatment programs that can help.

The NEA-BPD offers a wealth of printable and downloadable posters, graphics, and handouts that you can share both with your online social network and in your local community.  Consider accessing the following resources to share information about National BPD Awareness Month this month:

The McLean Hospital BPD Family Guidelines flyer is a comprehensive 11-page lifesaver for families of BPD-affected individuals.

The BPD Fact Sheet gives the latest statistics and initiatives underway to better support BPD-affected individuals and their families.

The BPD Brief offers a comprehensive overview of the origins, symptoms, and current treatment options.

The BPD Awareness Month Flyer is designed to reach out to those who are suffering in secrecy and silence with a message of hope.

Most importantly, if you or someone you love is suffering with BPD, or is displaying symptoms frequently associated with the onset of BPD, do not wait. I encourage you to contact one of the following national organizations for information about BPD support and treatment resources in your area:

National Alliance of Mental Illness (NAMI): http://www.nami.org/

National Institute of Mental Health (NIMH): http://www.nimh.nih.gov/

National Education Alliance for Borderline Personality Disorder (NEA-BPD): http://www.borderlinepersonalitydisorder.com/

And if you live in or near Davidson, North Carolina, visit www.southlakecounseling.com to learn more about our specialized BPD treatment programs. At the Southlake Center, we offer a full course of individual and group Dialectical Behavioral Therapy (DBT) options for BPD-affected individuals and their families.

Be Well,

Kimberly

Your Say Yes to Life Monday Motivator: Good News – BPD Brains ARE Different!

This month marks the 4th anniversary of May as National Borderline Personality Awareness Month.

Borderline Personality Disorder, or BPD, is a serious psychiatric illness which affects an estimated six percent of the population – approximately 18 million Americans. BPD is an excruciatingly painful emotional dysregulation disorder that can be both debilitating and deadly.

Affected individuals frequently first begin showing signs of the illness in early adulthood, often suffering for five years or longer before an accurate diagnosis is made. In that time period, BPD sufferers are 400 times more likely to commit suicide than non-affected peers. Affected individuals often cycle in and out of psychiatric care centers, encountering blame, shame, and stigma instead of the knowledgeable treatment BPD demands and deserves.

Symptoms of BPD include recurrent suicidal urges or attempts, chronic emotional instability, relational chaos, intense and persistent fear of abandonment (real or imagined), impulse control issues, rageful outbursts, and self-harm. While some BPD-affected individuals are able to function well in certain areas of life, others are unable to hold down a job or maintain basic relational connections.  Medical professionals estimate that as many as one in five out of every patients admitted to psychiatric care centers are suffering from undiagnosed BPD.

With these statistics, it is clear that much work remains to be done to better understand the origins and development of BPD, and what type of treatment most effectively assists affected individuals with recovery.

What is already known is that BPD is often passed from parent to child, with a nearly 70 percent likelihood that an affected person has had a parent who also suffered from the illness.

What has not been understood to date is whether or not there are true grounds for treating BPD as a brain-based illness, but recent studies at Baylor College of Medicine and The Mount Sinai Medical Center are now changing that.

In 2008, Baylor College of Medicine conducted a first-of-its-kind research study that aimed to identify whether the brains of BPD-affected individuals function differently than the brains of non-affected peers. This study paired a BPD-affected individual with a non-affected partner to play a game of trust. Researchers used fMRI (functional Magnetic Resonance Imaging) scans to measure how the brains of BPD-affected individuals processed emotional and relational cues from their non-affected partners as the game progressed.

To do this, Baylor research scientists measured blood flow to the anterior insula of the brain, the region that is thought to be responsible for sending up a “red flag” that something is wrong.  As the games of trust progressed, fMRI scans showed that when trust was broken, the anterior insula in the brains of non-affected individuals would register increased blood flow. No such activity was measured in the brains of BPD-affected game players, which for scientists was a clear signal that BPD sufferers do not process relational cues with the same acuity and intensity as non-affected peers.

The outcome of the Baylor study showed that BPD-affected individuals lacked the basic ability to pick up on social cues from their non-affected partners. Scientists now believe this difference in brain function is responsible for the persistent and often pervasive relational instability which BPD sufferers exhibit.

In a second study conducted just one year later in 2009 at The Mount Sinai Medical Center, research scientists snapped into place yet another piece of the brain-based puzzle that is BPD. In the Mount Sinai study, researchers set out to discover why BPD-affected individuals experienced chronic inability to self-regulate emotions. Paired against a control group of non-affected peers, 19 BPD sufferers viewed a series of pleasant and disturbing images, and researchers used fMRI scans to measure blood flow to the amygdala, or emotion processing center of the brain. When BPD-affected participants viewed the disturbing images, blood flow to their amygdala far outpaced amygdala responses of their non-affected control group peers.

Mount Sinai researchers are using this information to better understand the origin of the extreme emotional reactions BPD sufferers often display. The hope is that in the future, this information can be used to target medications and treatments to better serve the recovery needs of BPD-affected individuals.

Both the Baylor and the Mount Sinai studies offer good news to BPD-affected individuals and their loved ones. With now conclusive evidence that brain-based differences exist between BPD sufferers and non-affected individuals, a new and hopeful horizon for better treatment options for BPD sufferers is coming into view.

To read more about the Baylor study: CLICK HERE

To read more about the Mount Sinai study: CLICK HERE

If you or someone you love is suffering from BPD, or if you have or observe in a loved one symptoms that match those outlined in this post, I urge you to contact Southlake Counseling today for assistance in recovering from this painful but very treatable disease. Learn more at www.southlakecounseling.com.

Be Well,

Kimberly

Your “Say Yes to Life” Monday Motivator: Staying Away From the Borderline

May is Borderline Personality Disorder Month. This month, in honor of this important topic, we began a new blog series that focuses on the nuts and bolts of borderline personality disorder (BPD), and each week in May we will address a different aspect of recovery from this highly treatable disorder.

This week, we look at the role of the professional in the recovery process.

Perhaps no other disorder has been so extensively misunderstood, misdiagnosed, or misrepresented as BPD, so much so that mental health professionals are often reluctant or downright resistant to working with BPD sufferers. “I stay away from the borderlines,” one professional was heard to say at a recent conference.

Three decades ago, before the creation of Dialectical Behavioral Therapy (DBT) by Dr. Marsha Linehan, a response like this would have been more than understandable. However, in light of all the resources professionals have at their disposal today to treat BPD sufferers, hearing this at a conference in 2010 is puzzling.

BPD is essentially a disorder of relationships. As such, understanding the nuts and bolts of how the disease arises and what sufferers need to overcome its effects can go a long way towards reducing stigma and offering sufferers the type of professional treatment they need to get better.

According to the National Education Alliance for Borderline Personality Disorder (NEA for BPD), representative BPD symptoms include:  fears of abandonment, intense mood shifts, impulsivity, problems with anger, recurrent suicidal behaviors or self-injurious behaviors, and patterns of unstable and intense relationships that often create chaos in the lives of sufferers and their families.

In short, individuals with DBT can’t stand to be with themselves, inside their own intensely emotionally-charged skins, but through their behaviors they often recreate the very relational abandonment they fear, which exacerbates their symptoms, and so on and so on. It is thought that the stage is set for BPD, which is often diagnosed in early adulthood and primarily in females, through early emotional invalidation with a possible genetic biological component.

What is most important for professionals to know, however, is that it is highly treatable.

Even with this awareness however, one initial challenge treating professionals will face is to separate out BPD symptoms from other frequently co-occurring disorders. As the NEA for BPD reports, borderline symptoms rarely occur in isolation, and are frequently exacerbated by other concerns such as substance abuse, eating disorders, depression, anxiety, and bipolar disorder. While individuals suffering from BPD symptoms are often medicated, it is also important to know that no medication has been specifically approved for use to treat BPD symptoms as of yet.

Additionally, there are many ways in which the core symptoms of BPD can manifest, and those symptoms may vary based on each individual’s background, life experience, and prior treatment experiences. With an estimated 2% of the population suffering from BPD symptoms, it can quickly become a source of professional frustration to find one method to treat so many individual cases.

This is where Dialectical Behavioral Therapy (DBT) comes in. Dr. Marsha Linehan, the founder of DBT, categorized the six major categories of BPD symptoms into four skills-building modules. These four core modules include Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. DBT, while used today to treat a variety of mood-based disorders, was created specifically to treat individuals with borderline symptoms, and is scientifically proven to be a highly effective and lasting treatment approach.

Dr. Linehan’s goal when developing DBT was not to separate out, categorize, and individually address all 200+ permutations of the core BPD symptoms. Rather, she aimed to – and succeeded at – identifying instead the four core areas of coping skills that were missing from each BPD sufferer’s internal life coping toolkit. BPD sufferers all struggle to maintain mindfulness about who they are and how they fit in with others. BPD sufferers all wrestle with regulating their emotions and managing feelings of distress. BPD sufferers all have trouble developing trust-based, healthy relationships with themselves and with others in their lives.

In summary, BPD sufferers can all benefit from the four core modules taught through DBT.

For sufferers, loved ones, and referring or treating professionals, DBT is a bright light of practical hope amidst the darkness of a struggle against BPD symptoms.

At Southlake Counseling, we have more than two decades of clinical expertise in treating individuals with BPD symptoms through our DBT outpatient programs. Our combination of individual and group support, with additional phone support if necessary, puts BPD sufferers on the road to lasting recovery. We are happy to talk with loved ones and referring professionals about how DBT skills-building treatment can positively intervene in the life of someone struggling with BPD. We have expertise with adolescents, females, and males and offer individual and group support for individuals at each stage of the recovery process. Visit us at www.southlakecounseling.com – we look forward to hearing from you.

Be Well,
Kimberly

Your “Say Yes to Life” Monday Motivator: Making It Across the Borderline

May is Borderline Personality Disorder Month. Last week, in honor of this important topic, we began a new blog series that focuses on the nuts and bolts of borderline personality disorder (BPD) and each week in May we will address a different aspect of recovery from this highly treatable disorder.

This week, we look at the role of the family in the recovery process.

If your loved one has been diagnosed with borderline personality disorder (BPD), you probably reacted initially with equal parts relief and consternation.

The relief? “Well thank goodness we at least have a name for ‘it’ now!”

The consternation? “What can we do to help?”

The good news is that effective treatment is available. Two decades ago Dr. Marsha Linehan developed a (then) new therapeutic process known as “Dialectical Behavioral Therapy” or DBT. DBT was specifically created to effectively interrupt the BPD emotional cycle and replace those thoughts and behaviors with new coping skills. Students of DBT learn new skills in four core modules – Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. While DBT is used to treat a variety of mood-based disorders today, it was specifically designed to dramatically improve the lives of those diagnosed with BPD.

Family members and loved ones are also an important part of the individual’s recovery process, and knowing how to effectively participate can go a long way towards ensuring eventual full recovery.

In the absence of guidance, it can be tempting for family members and loved ones to pull away, thinking that less is more, and at least the person will not be harmed by the wrong kind of support.  However, this will be perceived by the individual suffering from BPD as yet another instance of abandonment, exacerbating symptoms and delaying recovery.

What is needed instead is a two-pronged approach beginning with the realization that no family member or loved one, no matter how well-intentioned, is equipped to manage the recovery process of an individual diagnosed with BPD. BPD is a serious, potentially fatal disease, and is worthy of both the highest respect and comprehensive professional treatment. BPD is not a self-willed disease – in other words, the sufferer cannot help their behavior outside of the intervention of trained professionals who know how to help break through the emotional gridlock inside and guide the sufferer to safety.

So the first step to take as a concerned family member is to ensure your loved one is receiving appropriate and adequate professional medical treatment.

Once this first step has been addressed, family members are now able to join in to support the individual through the recovery process. The National Education Alliance for Borderline Personality Disorder (NEA for BPD) has issued specific guidelines to help family members and loved ones participate effectively and constructively. A brief overview of these guidelines is found below and more information can be obtained on the NEA for BPD website at www.borderlinepersonalitydisorder.com.

The first recommendation is to “go slowly”. In other words – in the initial stages, fear of change and fear of abandonment through change is very high in the mind of the sufferer, who may exhibit resistance to treatment and change for precisely these reasons. This is not unique to a BPD sufferer – family members can build their “patience muscles” by considering areas of their own lives where change is both needed and feared. The NEA for BPD also advises family members to refrain from encouraging the sufferer with “you can do it” messages – these may increase anxiety and slow actual progress. Rather, family members are encouraged to eschew overt praise at noticeable progress and instead validate the hard work involved while still empathizing with how difficult the change process must be. Wrapped in with this is an encouragement to avoid discussion of achieving big goals – again, family members can flex their patience muscles by contemplating how desired change has happened in their own lives, and by setting small, realistic goals for the sufferer with the help of the professional treatment team.

The second recommendation is to modify the home environment in any way necessary to achieve what the NEA for BPD calls a “calm and cool” environment. This may mean something as simple as maintaining predictable daily family routines. Other ideas that are effective are making efforts to moderate intense emotional displays (whether positive or negative), minimize defensiveness in response to the individual’s thoughts and behaviors, and set limits on what will and won’t be tolerated to preserve the sanity and safety of the family unit.  Becoming educated about BPD symptoms and fears – for example, intolerance of being left alone, inability to discern “grey” emotional areas, and inability to self-sooth – will also assist family members with developing patience, compassion, and appropriate responses throughout the recovery process.

Finally, the NEA for BPD urges family members to seek prompt professional attention for BPD-related behaviors, such as self-harming, self-medicating through alcohol or other substances, or suicidal thoughts or behaviors. These behaviors are serious and reflect an intolerable inner environment that requires immediate professional intervention. Getting the sufferer prompt attention preserves not just safety and sanity but paves the way for development of secure emotional bonds that lead to eventual full recovery.

At Southlake Counseling, we have more than two decades of clinical training and experience implementing DBT-based treatment programs. Our wealth of individual and group support for males and females, adolescents and adults is unique in the Davidson area. If you or someone you love is exhibiting borderline personality disorder symptoms, contact us today at www.southlakecounseling.com to find out how DBT-based treatment can help.

Be Well,

 Kimberly

Your “Say Yes to Life” Monday Motivator: On the Borderline

May is Borderline Personality Disorder Month.  In honor of this important topic, we will spend the month of May addressing different aspects of recovery from this highly treatable disorder.

This week we will focus on the nuts and bolts of what borderline personality disorder (BPD) is, what treatments are available, and recommendations for finding support for yourself or a loved one.

Just hearing the phrase “borderline personality disorder” can strike fear into the hearts of the most resilient loved ones.

But for the individual who is diagnosed with borderline personality disorder (BPD), there is probably just a question mark where comprehension should be. This person is probably thinking, “BPD? What is that? This is just how I am!”

Therein lies the difficulty in accurately diagnosing, assessing, and treating BPD. To the professional untrained in BPD treatment, a sufferer can seem like an exercise in unpredictability, not to mention a source of continual professional self-doubt and frustration.

To the loved ones, often unwittingly caught in the disease’s trap along with the sufferer, BPD can appear as a nightmare of confused interpretations that never ends.

To the sufferer, it is just another day in a life filled with emotional pain.

Statistically-speaking, studies indicate that 2% of the population is thought to suffer from BPD. Additionally, up to 20% of all psychiatric hospitalizations stem from BPD. It is thought that nearly three-quarters of all sufferers are female, which is why current research and treatment continues to focus on females.

But what is it? What does “borderline personality disorder” even mean?

Simply put, BPD places the individual at odds with her own emotions. Emotional ups and downs are experienced as equally painful, chaotic, and unmanageable. Any other symptom traditionally associated with BPD can be traced back to this internal emotional war. Because the emotional instability is so severe, BPD is considered both serious and life-threatening. Self-harming and suicidal thoughts and behaviors are common. Relationships are a continual challenge due to continual mood swings and poor sense of self-identity. Treatment is a must – for the sufferer’s sake, and for the sake of those around them.

What causes BPD? While research is not yet able to pinpoint the exact causes, one thing is clear – it is not a self-willed disorder, and it is not the sufferer’s fault. Newer scientific evidence strongly points to a dual dance of biology and environmental triggers. For instance, while studying the brains of individuals diagnosed with BPD, researchers noted higher activity in parts of the brain that control emotional expression and experience, including the limbic system, the brain’s emotional processing center. For these and other reasons, it is widely thought that BPD-predisposed individuals’ brains differ not just in function but also in structure. This evidence also illuminates one possible reason for the tendency the disorder has shown to run in families.

Environmentally, an individual is considered at higher risk for developing BPD after experiencing childhood trauma or an invalidating emotional bond with early caregivers – or both. Since the disorder tends to first show itself in early adulthood, environmentally it appears that an earlier experience of traumatic emotional invalidation is a key factor in determining who is at risk for BPD later on in life.

But while it can be tempting to spend vast amounts of time digging into a sufferer’s past for clues as to why BPD has developed, the most important call to action is to get that person HELP.

Up until a few short decades ago, treatment options were scarce. But thanks to the pioneering work of Dr. Marsha Linehan, the founder of Dialectical Behavioral Therapy (DBT), there is much hope for successful treatment of this persistent and often resistant disorder. Dr. Linehan developed DBT specifically for the treatment of individuals suffering from BPD after studying their symptoms extensively and determining a range of four core building blocks needed to successfully overcome the disorder.

This is good news for sufferers, loved ones, and professionals. Sufferers who become students of DBT learn key coping techniques in Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. These four core modules are introduced over a period of time in an atmosphere of comprehensive individual and group support, including extra phone support if needed. The end result is an individual who is equipped with all the tools and resources she needs to combat her tendencies toward emotional overextension and self invalidation. Since the instruction is done in a nurturing and emotionally-validating environment, the individual is repairing old hurts while learning new skills, and emerges a stronger, more confident person within herself and in her interpersonal relationships.

If you or someone you love is exhibiting signs and symptoms of BPD, it is important to seek help immediately. BPD is a serious disorder and deserves the highest respect. Do not attempt to manage symptoms of BPD for yourself or a loved one. The professionals at Southlake Counseling have dedicated more than two decades to proficiency in supporting individuals with borderline symptoms through the recovery process. We are here to help. Southlake Counseling offers a wide variety of DBT-based individual and group support, including phone support. Our support groups are offered for both females and males, adolescents and adults. Our comprehensive DBT outpatient program is designed to make immediate, measurable progress in reduction of symptoms and improvement in emotional functioning. Visit us at www.southlakecounseling.com to learn more.

Be Well,

Kimberly