Tag Archive for 'coping skills'

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

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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

Published on Monday May 24, 2010 in Borderline Personality Disorder. 0 Comments Tags: , , , .

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

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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


Published on Monday May 10, 2010 in Borderline Personality Disorder. 0 Comments Tags: , , , , .

Your “Say Yes to Life” Monday Motivator: Finding a Reason to Recover, Part I

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If you have ever found yourself thinking (or saying), “I don’t have a reason to recover”, “I can’t find a reason to recover”, “What’s the point of recovering”, “I don’t feel worth recovering for”, then the first thing you need to know is that you are not alone.

Everyone who has ever tried to recover or emerge from some significant trial has felt this way at one time or another. It is part of the human condition – to struggle, to doubt, to rally, and, for those who persevere, to triumph.

But what sets those who eventually do triumph apart from the rest?

George Lucas, pioneer of one of the most beloved movie series of all times, gets right to the heart of the matter when he says, “You have to find something that you love enough to be able to take risks, jump over the hurdles and break through the brick walls that are always going to be placed in front of you. If you don’t have that kind of feeling for what it is you’re doing, you’ll stop at the first giant hurdle.”

In this first of a three-part series on “Finding a Reason to Recover”, we will look at the power inherent in reasons. But what is a “reason”? The most commonly accepted definition is that a reason is “the basis or motive for an action, decision, or conviction.”

So this basis or reason is where we start our journey. We start here because where we start is also what motivates us for every step we take after the first one. Once we understand this, it is easy to understand how where we start is often the greatest predictor for where we end up.

The good news is that our reasons can change over time, and when our reasons change, our prognosis and the outcome of our journey changes with it.

Using Star Wars giant George Lucas’ quote as a guide, let’s look at how reasons and, as Mr. Lucas says, “find[ing] something you love”, interact. The interesting thing about this dynamic duo is that, in the intersection of our motivation and emotion, there we also find CHOICE. This is what Mr. Lucas is referring to when he says that you have to find something that you love enough to take risks – risks to promote, protect, and preserve what you love, and risks to say no to what stands between you and the fulfillment and continued protection of that love.

Recently model Kate Moss was asked what her motto for life is. She replied, “nothing tastes as good as skinny feels”. This shocked the world, not just because Moss appears to be advocating for pro-eating disorder culture, but primarily because Kate Moss is a mother herself to a seven-year-old daughter.

This is what happens when we are not willing to acknowledge that all of life comes down to a series of choices, and that two opposing choices cannot continue to indefinitely occupy the same space. For instance, what is the prognosis for Moss to maintain her current stance in the future if her impressionable young daughter takes Mommy’s words to heart?

In other words, how will Moss’ reasons change when they begin to affect her own daughter?

For that matter, how will your own reasons change when you realize that, whether you currently believe you are worth recovering for – can recover – can even see the point of recovering – that you will never have the chance to find out if you don’t act NOW to save your own life?

So this is where we start. When interviewed, fully ninety percent of those who attempted suicide by leaping off of the Golden Gate Bridge in San Francisco and survived told their interviewer that they realized on the way down that the problems they were killing themselves to escape were really quite solvable.

The same goes for you. And for us all. Life hands us problems – that is part of what life does. How we respond, however, is up to us. We can choose to respond with hopelessness or with positive action, and our outcomes will differ accordingly. Your eating disorder is but one of many ways in which, in the past and possibly still in the present, you have chosen to respond to the stresses and unknowns of life. Maybe you believed – still believe – that the eating disorder was the only way that you could adequately cope with your daily life.

But there are other ways that you can learn for responding and managing life’s uncertainties, and they are available to you if you want to learn them. However, you can’t learn them until you know what function and role the eating disorder serves in your life. It is helpful in this process of assessing your reasons, motivations, and choices to make a list of all the things that you believe your eating disorder provides to you. For instance, maybe your eating disorder provides you with a sense of protection, with a simple system to make sense of life’s complexities, with clear-cut daily goals….just make your list, and continue adding to it as new ideas arise.

Next, it is time to look at the cost of life with an eating disorder. What has the eating disorder prevented you from experiencing, seeing, or doing? Who would you be close to if the eating disorder did not consume so much of your attention and time? Who else that is important to you is being affected by your eating disordered thoughts and behaviors in a way that makes you worry for their wellbeing even if you feel disconnected from worry or concern for your own?

You will always be able to find reasons to stay sick. And, if you look for them, you will always be able to find reasons to get better. Your recovery prognosis really comes down to one simple act – which set of reasons will you choose to follow?

At Southlake Counseling, we understand firsthand the devastating effect than an eating disorder can have both on your life and on the lives of those who love you. We are pioneers in providing state-of-the-art, clinically-proven treatments for eating disorders in the Lake Norman area because we believe that every person has the right and ability to say “no” to the slow death of an eating disorder and YES to their own unique and precious life. If you or someone you love is struggling with disordered eating or an eating disorder, please contact us today at www.southlakecounseling.com. We look forward to your call, email, or visit very soon!

Be Well,

Kimberly

Published on Monday November 30, 2009 in Eating Disorders and Monday Motivator. 0 Comments Tags: , , , , .

Your “Say Yes to Life” Monday Motivator: How to Bounce Back (Developing Emotional Resilience)

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Resilience. We’ve all heard the word….but what does it mean? There are plenty of definitions out there, but my favorite is actually a very simple explanation credited to the world-renowned Mayo Clinic: “[to have resilience is to] improve coping skills so that you can handle life’s hardships better.”

Beyond that, something else that is less recognized about resilience is that it also allows us to better enjoy life’s wonders. When we possess resilience, we retain our grasp on the bigger picture even in the midst of momentary valleys…or peaks.  In other words, when we develop emotional resilience, we learn to find a mid-point from where we can become mindful observers of as well as productive participants in our own lives. We can weather a storm because we know it will not last. And we can welcome a joy, even while knowing that at any moment, the winds might shift again and present a sorrow in its place.  

In short, resilience brings steadiness into our daily life experience. It gives us hope and optimism during tough times, and hope and optimism during wonderful times too.

This is also why emotional resilience is considered to be a key facet in our developing emotional intelligence. Emotional intelligence, or our ability to identify, assess, and maintain our own emotional wellbeing within the larger context of encountering the emotions of others and groups we belong to, factors heavily into determining our chances of achieving life success.

The good news is that emotional resilience is a learned skill.

You may also find it reassuring and encouraging to know that one of the most valuable lessons I have learned from the difficult times in my life is that difficulty is often a gift in disguise.

When we successfully confront and navigate life’s unexpected challenges, we also receive the opportunity to gain strength and find new meaning in life. Interestingly, in developing emotional resilience we experience something akin to what happens when we break a bone – at first, the bone is fragile and takes some time to knit back together. But, once the new bone has completely grown in, the result is a bone that is stronger than it ever could have been before!

So now we will look at eight key characteristics that can help you develop emotional resilience:

A Sense of Hope and Trust in the World:  When you are resilient, you lean into your belief in the basic goodness of the world when times get tough. You are vigilant about maintaining your trust that things will turn out all right in the end, and this positive attitude allows you to weather life’s storms by always seeking the ray of light peeking out through even the blackest of clouds.

Interpreting Experiences in a New Light: When you are resilient, you have developed the ability to look at a situation in a new way (a skill called “reframing”). This approach helps you to minimize the emotional impact a difficult situation brings. Resilient people take a creative approach toward solving a problem, and are willing to approach new challenges with optimism and an open mind.

Understand and accept emotional experiences: When you are resilient, you know that your feelings and emotions exist for a reason.  Rather than judging your emotions and spending precious reserves of time and energy labeling them as “good” or “bad”, “necessary” or “unnecessary”, you instead channel your efforts into reading the road signs of your emotional map to find your way back to centeredness, peace, and wellbeing even in the midst of life’s unexpected and stressful moments.  

A Meaningful System of Support: When you are resilient, you know that you can’t get through hard times without help. Furthermore, you are willing and able to tap into networks of support when you need help because you understand that isolation is not your friend during a crisis. Resilient people aren’t stoic loners. They know the value of expressing their fears and frustrations, as well as receiving support, coaching or guidance from friends, family or a professional.

A Sense of Mastery and Control Over Your Destiny: You may not be able to predict the future, but when you are emotionally resilient you can put aside that which you are unable to control and focus your attention on elements that are within your sphere of influence. Resilient people know that ultimately their survival and the integrity of their life values depend on their ability to take action rather than remain passive. Tough times call for you to tap into your own sense of personal responsibility and ability so that you can “be the change you wish to see in the world” (thanks, Gandhi!)

Self-Reflection and Insight: When you are resilient, you understand that your life experiences provide fertile ground for learning and growth. You use times of challenge as an opportunity to ask yourself questions and learn more about who you are and what matters to you. You know how to use your thoughts and feelings to gain insights you need to find your way through emotional distress to hope again. Resilient people learn from life situations and understand that the only sensible approach to challenge is to stay centered in the moment, where anything is possible.

A Wide Range of Interests: When you are resilient, you can always look around and find something new and interesting to focus your attention on. The wider your range of interests and activities, the more motivation you will have to do the hard work of maintaining optimism during troubling times. Your array of interests and relationships will also help you stay open to new approaches and perspectives for problem-solving. Resilient people have learned to productively channel some of the unavoidable worry and anxiety that hard times bring into rewarding pursuits.

Sense of Humor: When you are emotionally resilient, you know exactly how powerful a good laugh can be! By cultivating your ability to see the absurdity, irony, or genuine humor in a situation, you also rekindle your sense of hope and possibility during even the toughest situations. Humor has both psychological and physical benefits in relieving stress because it encourages a swift change in your perception of your circumstances—when your thoughts change, your mood quickly follows.

At Southlake Counseling, we understand that it takes time to develop emotional resilience, and that having the support of skilled and caring professionals as well as friends and family can be a tremendous support during times of emotional distress. Furthermore, we know that an ounce of preparation for the inevitability of life’s hard times can be priceless in terms of the message it sends to us each and every day that we are worth surviving and thriving for.

Southlake Counseling professionals are highly trained in a wide variety of modalities that are useful in developing emotional resilience, chief of which is Dialectical Behavioral Therapy, or DBT. Students of DBT learn four core skills to develop emotional resilience, including mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.  

Southlake Counseling is the recognized leader in the Lake Norman area for DBT-based individual and group support – our commitment to providing superior quality DBT training is fueled by our commitment to helping you say “no” to emotional distress and YES to life lived in the presence of the hero within.

If you would like to learn more, please visit us at www.southlakecounseling.com today.  We look forward to your call, email, or visit!

Be Well,

Kimberly

Published on Monday November 23, 2009 in Dialectical Behavioral Therapy (DBT) and Monday Motivator. 0 Comments Tags: .

Surviving the Holidays

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Like it or not, ready or not, once again they are coming. Before we’ve even processed Labor Day, we see the decorations going up for Halloween. Halloween is not even over and already there are stuffed turkeys and pilgrim hats lining the shelves. And about a week before Thanksgiving we find ourselves getting confused about which holiday to prepare for because everywhere we look, we see nothing but mistletoe and fake icicles and Santa Claus.

Sometimes it seems like the media and corporate America get more excited about the holidays than we do….because we are too busy managing the anxiety and stress caused by non-stop pressures to buy more than we can afford, see people we don’t like or don’t know (or both), and eat foods we would never otherwise consider consuming just to be accommodating to great aunt Lucy who has been cooking her signature pumpkin pie-flavored raisin fruitcake since the early 1900’s…..

But this year, the holidays can be different. Each holiday season is like a milestone in our lives, when we can look back on where we were and what worked (and what didn’t) the year before and celebrate how much we’ve learned and grown in the twelve months in between.

This is why the best way to tackle the holidays this year is to examine what worked and what didn’t last year and make adjustments from there. So here are some questions to contemplate and journal about that can help make the holidays feel less like an onslaught and more like a celebration:

Where did you struggle the most during last year’s holiday gatherings (dinner table, family interactions, isolating to avoid conflict, whatever it is)?

What ideas do you have to prepare in advance for how to navigate similar challenging moments that may reoccur this year?

What kind of support did you need last year that you didn’t have that could have made a difference?

Do you have a strong support team (professional and loved ones) going into this holiday season?

If not, what can you do now – today – to add supportive others to your team?

At Southlake Counseling, we know how it feels to watch the holidays rushing headlong at us, delighting our eating disorder/anxiety/depression and terrifying us. We also know that what is great about the holidays is that they force us to take action – NOW – to protect and care for ourselves.

If you need help and support as the holiday season approaches, we invite you to contact us today. We are looking forward to partnering with you to find ways you can say “no” to holiday stress and “yes” to a celebration of love, gratitude, and life!

Be Well,

Kimberly

Published on Wednesday November 18, 2009 in Uncategorized. 0 Comments Tags: , .