Your Say Yes to Life Monday Motivator: Self-Care During the Holidays

Your spouse just told you that your in-laws are coming to your house this year.

Again.

But what is different this year than before is that your cousins have decided to caravan down with them and come to your home for the holidays too.

Furthermore, since you have a large backyard, they have decided not to kennel their two dogs, one gerbil, and three cats. No need – your house has enough room for them all!

As your spouse relates all of this to you, you feel your blood pressure starting to rise.

You try to explain, but your spouse just doesn’t seem to get it. And it is little wonder that he doesn’t – you can still remember last year, when you envied him his stressful, hectic city job that allowed him to escape the bedlam and chaos that was your home this time last year.

He didn’t see how demanding his folks really are of you. He didn’t realize how worn out and exhausted you felt at the end of every day – how spent, and drained, and just ready for the whole thing to be over.

You are dreading it at a level you didn’t even think you were capable of. The holidays haven’t even started yet, and already you are ready for them to end.

Luckily, you have been taking a group therapy course in Dialectical Behavior Training (DBT) over the past several weeks, and what you are learning is giving you a fresh perspective on how to handle the family situation this year.

First things first – practicing mindfulness, you note your reactions to your spouse’s announcement. The rage. The frustration. The resentment. The air of finality to it – you are being told, not asked, if it is okay to host his extended family this year. You bring your newfound ability for “radical acceptance” to bear on the situation – calmly, you practice simply accepting the moment for what it is, rather than what your mind thinks or wishes it to be. First, accept. Next, work to change.

That accomplished, you pull out mindfulness’ trusty sidekick, emotion regulation. Using your new skills in emotion regulation, you begin to name each emotion objectively, like a witness or observer, rather than an active (and highly emotional) participant. Yup, that really is rage. Yes, there is frustration too. And resentment. Definitely resentment. Some sadness too – when will you and your spouse ever get a chance to enjoy the holidays just relaxing together? Okay, and relief is also coming up – because this year, you have a plan to use your new DBT skills to transform events in a way that includes your need for self-care and alone-time, as well as couple time and family time, into the mix.

Next up is distress tolerance. You realize you are feeling a lot of distress due to all the emotions suddenly arising and colliding within you. You take a deep breath, relax into an awareness of a bigger picture behind your momentary stress, and then let your breath out again, dropping your shoulders and softening your facial muscles as you do so. You remind yourself that you can deal with this situation, you do have it in you to find a workable solution, and you are okay, even in the midst of some significant emotional distress.

Finally, you begin to pull it all together into interpersonal effectiveness. Now is the moment when you will assert your needs – and household ground rules – with your spouse, sharing with him how you are feeling, what you need, and what you can and cannot offer to make the holidays with his family a success this year. You decide that you will initiate a calm, objective conversation with your spouse, free from excess emotion or last year’s holiday baggage, blame, or shame.

Still very calmly, you ask your spouse if he could join you at the kitchen table for a few moments to strategize. You share with him that you did not enjoy the holidays last year and have a plan for how this year’s time with loved ones can be different. You outline what you are willing and able to do to support his in-laws’ visit, and what you need from him in terms of his participation in the family holiday preparations. Then you ask him how he feels about participating in the ways you have outlined, and whether it is something he can commit to. You ask for his feedback as well, and together, you begin to open up to one another and admit that having the whole family in to stay is stressful for you both.

In other words, as you open up, mindfully, with calmness, centeredness, focus, and objectivity, sharing what you need as well as what you wish to offer to make the family holiday season a success, you give your spouse permission to do the same.

Together, using DBT as your guide, you begin to talk through creative ways to turn last year’s holiday woe into this year’s holiday wonder.

If you are finding that you are struggling this holiday season to find the wonder in the midst of the woes, Southlake Counseling can help. Our compassionate and skilled staff has more than two decades of experience with guiding individuals in how to effectively use the DBT principles of mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Learn more by visiting us at www.southlakecounseling.com.

Be Well – and happy holidays!

Kimberly



Your Say Yes to Life Monday Motivator: Turning Holiday Woes into Holiday Wonders

Oh boy. The holidays are here.

Again.

You are not sure whether you have been anticipating this moment all year, or dreading it.

Or maybe a bit of both.

Nevertheless, here they are again – upon us for yet another season, and once again before we are ready for them to come. So now the question becomes not “where can I hide?” but rather “what am I going to do differently this year?”

That is what we are going to discuss in this month’s blog series “Turning Holiday Woes into Holiday Wonders.”

For our series, you have been my inspiration, because each one of the woes I have selected is one I have heard you share with me in private session year after year, right around this time.

For instance, you have shared with me how hard you find it to carve out time for self-care while feeling called to take extra special good care of others as well.

You have told me that sometimes it feels simply impossible to locate the fine line between treating yourself to holiday goodies and maintaining your physical health and nutrition.

And you have confided that you sometimes – often – find it incredibly difficult to release a whole past year’s worth of errors and triumphs only to discover an entirely new, sparkling fresh year sweeping down on you before you have had any time to prepare for its arrival.

So this month, we will examine strategies to turn each of these woes into wonders, one week at a time. To do this, we will revisit one of my favorite therapeutic approaches for recovery and life – Dialectical Behavioral Therapy, or DBT for short.

DBT is a wonderful pathway to effective daily living authored by Dr. Marsha Linehan. The focus and goal of DBT work is to stay centered, present, open, and willing to do our best in every moment.

The teaching tools that DBT uses include mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Each tool builds upon and integrates with the others, and when used together can produce a centered, balanced, present-focused approach to daily life during the holidays and at every moment of the year.

So before we begin our “woes to wonders” adventure together, let’s just take a quick review of each of the four key DBT tools we will be using:

  • Mindfulness training equips us to take back control over our mind’s thoughts and our reactions to those thoughts
  • Emotion Regulation teaches us to name and experience our emotions without allowing them to overtake us
  • Distress Tolerance cultivates our ability to stay present and focused for each moment of our lives regardless of what the day may bring
  • Interpersonal Effectiveness helps us to develop assertiveness skills to ask for what we want and need in safe, healthy, and affirming ways

It is easy to see how each of these tools becomes particularly essential during the heightened energy and emotion the holiday season ushers in. During the next few weeks, we will look at how to apply each of these skills to transform a traditional holiday woe into a true source of delight and wonder.

If you are finding that you are struggling this holiday season to find the wonder in the midst of the woes, Southlake Counseling can help. Our compassionate and skilled staff has more than two decades of experience with guiding individuals in how to effectively use the DBT principles of mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Learn more by visiting us at www.southlakecounseling.com.

Be Well – and happy holidays!

Kimberly

Your Say Yes to Life Monday Motivator: The Help We Need…and the Help We Don’t

This month, we have been discussing the process of asking for help. So far, we have broken this process down into three discrete events – noticing when we need help, asking for the help we need, and accepting that help when it arrives.

The fourth and final facet of asking for help comes as we learn to discern the help we need from the help we don’t. So in this final blog post in our “asking for help” series, we will examine what to do with offers for help we don’t need.

Imagine for a moment that you’ve been lost in the desert. You have been wandering around, looking for water. Everywhere you look, what appears to be a water source turns into yet another mirage. Finally, after days of wandering, you at last see a source of genuine water up ahead. You walk closer, closer, you break into run…..only to pull yourself up short when you realize….it’s the ocean.

You’ve found water, just not the right kind.

Accepting offers of help we don’t need is like drinking salty ocean water to quench our thirst. It is not only unproductive – it can be downright dangerous as well.

Furthermore, it is disrespectful to ourselves, because if we have made it this far in this blog series, we have earned our “asking for help” stripes, and we know when we need help and when we don’t, and what we need it for. We may even be starting to get comfortable with accepting help when it arrives.

But what do we do with help we simply don’t need? And why might we accept help we don’t need?

Let’s take an example. Let’s say that last weekend you had your pre-wedding shower. This afternoon, your soon-to-be mother-in-law with the illegible handwriting offers to help you write your wedding shower thank you notes….and you don’t know how to respond. On the one hand, you don’t want to do anything to damage a new family connection that will be in your life for years to come. Yet this will double your workload, and with all you still have to do to prepare for the wedding, you can already visualize yourself spending precious free time surreptitiously re-writing dozens of thank you cards and sneaking out to the mail box to pop them in when your mother-in-law-to-be isn’t looking.

So what should you do?

You could certainly graciously decline her offer, and explain that you already have everything well in hand. But the truth is, you don’t. You do need help in plenty of other areas as you prepare for your upcoming wedding – yet clearly the task she has volunteered to help you with is not the right task for her. So how about finding something else – some other way that your new mother-in-law could be of service?

One strategy you could try follows a simple four step approach I have often suggested to clients over the years:

  1. Thank the offering individual sincerely for their offer of help
  2. Let them know you will think about it, and get back with them
  3. In the meantime (or on the spot if something comes to mind right away) decide if there is something they could do that would truly help you, and if so, let them know what it is and ask if they would be willing to offer that help instead
  4. If the answer to number three above is a simple “no”, communicate that to them with gratitude and let them know you will surely contact them if you need help with that task or others in the future.

As we learn and practice new skills for how to identify and accept the help we do need, and how to graciously redirect or decline the help we do not need, we can begin to feel truly empowered in our relationships with ourselves and others.

At Southlake Counseling, we offer a wealth of personalized individual and group support services to help individuals just like you learn to access the courage and power to navigate your need for help self-supportively and effectively. If you are struggling to say no and yes to offers of help in self-respecting, empowering ways, we encourage you to contact us at www.southlakecounseling.com.

Be Well,

Kimberly


Your Say Yes to Life Monday Motivator: How to Accept Help

In the first two blog posts in our “asking for help” series this month, we discussed how we can re-activate our felt sense of needing help, and from there learn skills to ask for the help we need.

In this third post in our series, we will discuss the actual process of how we can get comfortable with accepting help when it is offered.

We may have allowed ourselves to get so wrapped up in our awareness of not being able to ask for help, or our belief that nobody around us is willing to offer help, that we have failed to recognize that we don’t feel comfortable accepting help.

Chances are, that is just because we have long since fallen out of practice.

But regardless of the reason, if we feel uncomfortable with accepting help, we may get all the way through the process of rekindling our awareness of when we need help, learning how to effectively ask for help, and then still not be able to actually accept the help we need when it is offered!

In my experience working with individuals who want to relearn how to ask for and accept help, this final phase is actually where many of us struggle the most.

As we make our way through today’s do-it-yourself culture, for many of us it truly is uncomfortable to allow ourselves to receive help! It doesn’t feel right, or normal, or natural, or comfortable – and women in particular may worry all the way through the process about imposing too much, asking too much, or being beholden to “return the favor,”  in the process adding so much extra work to our own plate that asking for help really does start to become as unproductive as we feared it would be!

So we have to start now – before we even ask for the help we need – to get comfortable with receiving it once it arrives.

We can do this in a number of ways. I have often found that visualization seems to work well as a tool to prepare ourselves for accepting help. It seems that when we feel prepared for the outcome of our actions, we are more ready to accept the end result when it arrives. So if we can visualize ourselves accepting help before it even arrives, we are more likely to recognize ourselves in that role when we are actually standing in the receiver’s shoes, and more likely to favorably experience what it feels like to accept help.

In this way, we can also give our imagination something productive to do. Our imagination is usually all too ready to dish out vivid mental pictures of how disastrous asking for and accepting help might be. With constructive, proactive visualization strategies, we can preempt its regularly scheduled programming and put it to work visualizing positive outcomes instead!

So this week, as you are building on what you have learned about recognizing when you need help, and asking for that help, also make sure to visualize yourself accepting that help when it comes. Visualize how you will express your gratitude (to avoid adding stress to the process, be sure to choose something simple, like saying a genuine “thank you” or sending a sweet short note). Imagine the process of how you will show the other person what you need, including giving them any instructions they might need in order to provide help. Think of what you will do with the energy and time you freed up by not trying to arm wrestle the problem to the floor all by yourself.

Then give yourself a hug and a warm smile full of gratitude for being willing to accept the gift of help when it is offered! This is a courageous act, and you deserve your own gratitude for stepping out of your comfort zone to notice when you need help, ask for that help, and accept it when it is offered.

If you notice you are struggling with accepting help, and you feel uncomfortable allowing yourself to accept help even when it is offered, please consider contacting Southlake Counseling. In more than two decades I have personally assisted hundreds of people to learn how to accept the help both easefully and gracefully. If they can do it, you can too. Southlake Counseling’s staff of caring, highly trained professionals can help you begin to say no to the exhaustion and frustration of withholding help from yourself, and YES to joyfully embracing the help you need and deserve. Visit us today at www.southlakecounseling.com

Be Well,

Kimberly


Your Say Yes to Life Monday Motivator: How to Know When We Need Help

In the more than two decades I have spent assisting courageous individuals who come to me seeking help for how to transcend challenges and embrace opportunities, I have noticed over and over again how hard our culture makes it for us to ask for help.

We may think that it is hard to accept help when it is offered, and that is often true as well. But that difficulty is nothing compared to how hard many of us find it to reach out and ask for help when we need it.

In fact, I have also noticed that the difficulty only sometimes lies with an actual inability to ask for help. For many of those I have met in the course of my life and work, the true challenge seems to be even knowing for sure when help is needed!

So I thought we would spend some time this month discussing how we know when we need help and how we can ask for help when we need it.

When we were little, we probably asked for help by crying. We had a limited emotional vocabulary, and tears were one of the few reliable ways we could communicate a felt need – even if we did not have a clear understanding of what that need was. We just knew we needed….something….we cried….and someone noticed and offered assistance. If necessary, we figured out what kind of assistance was needed together, but the presence of the tears was enough evidence in and of themselves that help was in order, and enough to send it running our way.

As we got older, however, it became less socially acceptable to literally “cry out” our need for help. As our tears went underground, our ability to sense our felt need for help went with it.  We learned that there was a cutoff age by which we could unselfconsciously ask for help without fear of ridicule, rejection, or censure. Once that cutoff age had been reached, we were deemed “old enough” to figure out how to help ourselves and we were on our own.

It was at this point that we most likely withdrew permission from ourselves to ask for help, or accept it when it was offered, or both.

However, even if it has been awhile since we have used it, we have never lost this ability to sense when we need help. Rather, we are just out of practice with tuning in.

This week, spend some time tuning in again to that innate felt sense of when you need help. As you do this, suspend any learned adult requirement that you must question your own felt sense of needing help, regardless of whether your need is small (lifting a heavy bag out of the car) or big (addressing a difficult relationship or work situation).

If necessary, pretend you are small again, and your felt sense of needing help is pure and trusted. Allow it to come up. Notice if it is preceded by a sudden feeling of sadness, anger, fear, or other emotion. Notice how you feel as you begin to translate a wave of previously inexplicable sudden feeling into a need for help. Do you feel fear? Resistance? Reluctance? Relief?

Being able to tune in to when you need help is the first step to being able to ask for help – we simply cannot ask for what we do not know we need. Knowing we need help is also the first step towards trusting ourselves enough to ask for it – if we cannot admit to ourselves that we need help, then we cannot allow ourselves to accept it, even when it is freely offered!

If you notice you are struggling to tune back in to your felt sense of needing help, or you are struggling against admitting to yourself that you are worth receiving the help you know you need, Southlake Counseling can help. Our professional staff is compassionate and experienced in helping individuals of every age and from every walk of life to relearn how to ask for and accept help. To find out more about how you can begin to say no to “going it alone” and YES to accepting and embracing help, visit us at today at www.southlakecounseling.com.

Be Well,

Kimberly


Love and Support in Action

On a recent weekend I had the great fortune of being at the Susan G. Komen Race for the Cure in Charlotte. Every year I’m amazed at the wonderful outpouring of support and love that I see at that event. I believe that 16,000 people participated and 1.6 million dollars were raised, of which 75% stays in the Charlotte area. As I was surrounded by all the love and support generated by all those people walking and running for their mothers, sisters, aunts, nieces, and friends, I thought about what a great way to “cope” with a sometimes devastating illness.

In Dialectical Behavior Therapy (DBT) Skills Training, the module on Distress Tolerance teaches various skills used to cope with painful situations and/or emotions. DBT operates on the principle that pain is inevitable, but suffering is optional. One of the skills featured in DBT is ACCEPTS. ACCEPTS is an acronynm standing for Activities, Comparisons, Contributing, Emotions, Pushing Away, Thoughts and Sensations.

Fundraising, walking and/or running for a cause such as the Susan G. Komen is an excellent example of something that involves Activities, Contributing and Comparisons, which is why an event like this and others like it are such a huge draw for so many, on so many levels. If you would like to learn more about DBT and the skills training group contact Southlake Counseling for more information.

In good health,

Shannon

Shannon T. Brewer, M.A., L.P.A.


Are You Willing To Do What It Takes?

I had an interesting conversation with a guy I know at a bicycle shop the other day. We started talking about my bicycle seat options and what might be more comfortable for me, so I asked him if it makes a difference that my pelvis healed into an uneven position after a car accident about 20 years ago. This led to a further discussion of lower back issues…neck and shoulder tightness, and he asked me if I have any chronic pain as a result of my injuries. I hadn’t really considered this in a while, so I shared with him that I had been a chiropractic patient for nearly two decades, visiting several times a year, anytime I felt a flare-up in my back, neck, or shoulders. However, I have been able to stay out of the chiropractor’s office for about the past two years, despite doing more physical activity such as cycling, which can exacerbate back problems.

“How do you explain that?” he asked. The answer was easy, “I practice yoga.”  He agreed that yoga is extremely helpful in developing what people need to stay active – balance, strength, and flexibility – and as a trainer he recommends it to nearly all his serious cyclists, but added that most people just won’t take the time to practice it. Hmmm…so this made me think.

In my work with clients, we quite often discuss ways that they can feel better – coping skills that they can use when they feel distressed, instead of returning to their old patterns of using food, alcohol, sex, self-injury, isolation, purging, or any other maladaptive trick that they have tried. The problem with these patterns is that, although they may temporarily “numb” us from feeling what is causing emotional pain, they end up causing harm and making things worse. So, like I tell my clients, when you take what you have been using away, you must learn to replace it with something that works…and here is where many people have a problem. Although we make a list of many other ideas that they can try when they start to feel uncomfortable, and they even admit that the new coping skills actually work, they fail to practice the willingness to continue to do what they know will help them…so why is that?

In our DBT groups, we learn about willingness vs. willfulness, and specifically how these concepts help or hurt us. Willingness is when we know what will help us feel and function better without making things worse in the long run, and we actually put those skills into practice in our daily lives. Willfulness, on the other hand, is when we know what would be the most effective way to handle a situation, what would work the best for us, and we choose not to do it.

There are many reasons why a person willfully chooses not to do what he knows will work. Sometimes people are familiar with and comfortable being in a constant state of chaos, and don’t believe they deserve anything better or different. Other times the pain of the harm they are doing is not enough to motivate them to change. Until that balance shifts and their suffering becomes worse than the discomfort associated with doing something new, many people won’t make the effort to help themselves.

In my own life, self-care is something I must stay willing to practice in order to be the best mom, daughter, friend, and therapist that I can be. It’s often difficult for me to carve out time to practice yoga, ride my bike, spend time with friends, read, and pray/meditate, on top of all my other responsibilities. But I have found that the more demanding my schedule is, or the more stressors I am experiencing, the more imperative it is that I take care of myself by doing all those things. It requires willingness on my part to make the effort, and the results are worth it in my happiness, stability, and peace of mind. I know what makes me feel better, so it’s my fault if I choose not to do those things.

Ask yourself today, “If I am unhappy with the way things are in my life, am I willing to do what it takes for me to feel better?” If your answer is Yes, and you need some guidance in figuring out what might work for you, schedule an appointment at Southlake Counseling and take the first step toward being in charge of your own happiness.

In good health,

Debbie





Acceptance and My Dear Friend

In my DBT groups, I teach skills to help clients cope with challenging or distressing situations in their lives, without making things worse. One of the skills that we work on is Radical Acceptance, which means acknowledging reality, accepting it for what it is, without judging it good or bad.  I share with clients that I understand how difficult it can be to radically accept certain things, and that this acceptance is the only way they can let go of suffering.

So now it has come time (yet again) for me to practice what I preach.  I received a phone call this week from one of my dearest friends in the world, and through tears and gasps, she told me that she has been diagnosed with stage IV colon cancer, metastasized to her liver to such an extent that the doctors say they cannot remove the tumors.  This is an extremely healthy and vibrant young mother of a precious 5-year-old, no family history of cancer, no risk factors whatsoever, and she’s one of those friends I can count on one hand – the true ones – so I’m supposed to accept this?

Trying to recover from the shock and wrap my mind around this devastating news, I pull out the “Radical Acceptance” bullet points I give to my clients when I tell them that accepting some things is very difficult…and I start to wonder if they feel as helpless and overwhelmed as I do right now. The first bullet point reads, “Freedom from suffering requires acceptance from deep within of what is. Let yourself go completely with what is. Let go of fighting reality.” Hmmm…I’m not sure I’m ready to accept this from deep within. You see, this is my friend Lea Ann. She is more like a sister to me, she “gets” me – we are so much alike we can finish each other’s sentences, so this feels too close. We’re like Lucy and Ethel, and I don’t remember either one of them ever having cancer. Letting myself accept this somehow feels like giving in, and I seem to remember my clients saying the same thing.

Another bullet point reads, “Pain creates suffering only when you refuse to accept the pain.” Okay, this one makes more sense to me. I’m no stranger to pain, and I’ve learned to feel what I feel when something is painful instead of avoiding it or pushing it away. Pain is there to teach us something, to inform us that we need to pay attention to what is going on, so what is this pain telling me?  I don’t have to search hard for the answer – my pain is there because Lea Ann is vitally important to me. She is the person who came to my side, dragging her husband and daughter, when my grandmother was in the hospital in Kentucky and I needed some answers. She was there with me when my dad died, and flew to be with me when I felt like falling apart a few months later. This pain is reminding me that what she has done for me is be there, and this is what I can do for her now – I can show up. This gives me purpose and something to do, so I start to feel better…slightly.

The last bullet point in the list reads, “To accept something is not the same as judging it good.” Oh…so I don’t have to like what is happening to Lea Ann in order to accept it…this is comforting. I hate what is happening to my friend and how it is affecting her sweet family. I hate what she will have to endure in order to have some hope of a more favorable prognosis. I hate feeling powerless and angry and sad all at the same time, and this radical acceptance thing tells me I don’t have to like it to accept it. So I go to work on accepting…

Radical acceptance reminds me of the Serenity Prayer, and I pray it a lot these days:

            God, grant me the Serenity to accept the things I cannot change,

            Courage to change the things I can,

            And the Wisdom to know the difference.

I know I cannot change my dear friend’s diagnosis nor the challenges she is facing, but I can be courageous enough to be there for her, offering all the support I can in friendship and love, which is exactly what she has always done for me. I am reminded of all the times my clients have been challenged to separate what they can change from what they can’t, and I feel more compassion than ever for how difficult this can be.

Most people aren’t familiar with the rest of the Serenity Prayer. The next lines read:

            Living one day at a time;

            Enjoying one moment at a time;

            Accepting hardship as the pathway to peace.

None of us knows what tomorrow will bring, and we can’t do anything about it until it gets here, so we might as well live in today. My friendship with Lea Ann has been blessed with enjoyable “moments” when we both howled with laughter and silliness – our Lucy and Ethel moments. Racing down Michigan Avenue before our favorite stores closed, betting on the horses at Keeneland with no idea what we were doing, jumping off a ski lift and getting stuck on the highest gondola in Canada, and savoring the times we’ve shared dessert. Such moments are the ones I remember and return to when hardship does come, for I know such is the reality of the ebb and flow of life.

If there is anything I’ve learned from my friendship with Lea Ann, it is that the most important thing I can do is be present, and live. Show up instead of sitting back, experience instead of analyze, accept instead of worry – say YES to life.

With sincere hope that my journey can inspire,

Debbie

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: 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