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BORDERLINE PERSONALITY DISORDER

While BORDERLINE PERSONALITY DISORDER is a serious condition that requires treatment by qualified mental health professionals, there are also sources of self-help (or self-guided strategies for symptom reduction) for individuals with BORDERLINE PERSONALITY DISORDER. These self-help strategies should be used in conjunction with formal treatments for BORDERLINE PERSONALITY DISORDER (such as psychotherapy and medication).

The symptoms of BORDERLINE PERSONALITY DISORDER, including erratic mood shifts, self-harming behaviors, suicidality, intense emotional experiences, sensitivity to problems in your relationships and problems with impulsive behaviors, may all be related to one core feature: emotion dysregulation, where individuals have very strong emotional responses, difficulty managing those responses and often engage in harmful behaviors in attempts to escape from these emotions. Recovery strategies can help to reduce emotion dysregulation and the other symptoms of BORDERLINE PERSONALITY DISORDER.

What are Recovery strategies?

Since emotion dysregulation is such an important feature of BORDERLINE PERSONALITY DISORDER, many treatments for BORDERLINE PERSONALITY DISORDER emphasize the importance of building recovery strategies to better manage emotions when they arise. What exactly are recovery strategies? They are healthier ways of addressing situations and their resulting emotions.

Why Learn New Recovery strategies?

Why is it important to learn new, healthier ways of coping? By using healthful recovery strategies you may:

• Build confidence in your ability to handle difficult situations
• Improve your ability to be able to continue to function well even when in stressful circumstances
• Reduce the intensity of the emotional distress you feel
• Reduce the likelihood that you will do something harmful (e.g., engage in self- harming behaviors) to attempt to escape from the emotional distress
• Reduce the likelihood that you will engage in behaviors that destroy relationships (e.g., physical aggression) when you are upset
• Ultimately reduce your overall experience of emotion dysregulation

What are Some Different Types of Recovery strategies?

There are literally thousands of different recovery strategies that individuals use to manage stressful situations and the emotions that result. Here are a few types of recovery strategies that work for many individuals:

• Active Problem-Solving. Consider the problem at hand: Is there a way to solve the problem directly?
• Behavioral Activation. Engage in an activity that might take your mind off the stressful situation for a little while.
• Grounding. Practice grounding exercises that are designed to keep you "grounded" in the present moment, rather than caught up in replaying events in your head, worrying about the future or zoning out.
• Mindfulness Meditation. Practice mindfulness meditation, which helps you to observe and describe your experiences without judging or rejecting them.
• Relaxation Exercises. Practice a relaxation exercise, such as deep breathing or progressive muscle relaxation.
• Social Support. Talk to others who may understand what you are going through.

How To Learn Healthier Recovery strategies—

Ready to learn some new, healthier ways of coping? One way to do this is by seeking treatment. Many psychological treatments for BORDERLINE PERSONALITY DISORDER, including cognitive behavioral treatments such as Dialectical Behavior Therapy (DBT), focus on teaching healthier recovery strategies to manage strong emotions. There are online resource pages that can help you find a cognitive behavioral therapist or a DBT provider.

When you are having an intense emotion, it can be hard to know what to do. Unfortunately, many individuals with BORDERLINE PERSONALITY DISORDER turn to unhealthy behaviors in an attempt to cope with emotional pain (e.g., self-harm, substance use, or aggression). Want to replace unhealthy habits with new, healthier skills? Try some of the recovery strategies listed below.

1. Be Mindful— Practice mindfulness of your emotion. Notice the emotion you are having, and let yourself experience it as a wave, without trying to block it, suppress it, or hold on to it. Try to accept the emotion for what it is.
2. Breathe Deeply— Sit or lie somewhere quiet and bring your attention to your breathing. Breathe evenly, slowly, and deeply. Watch your stomach rise and fall with each breath.
3. Call Someone— Reaching out to others can really help when you are struggling with strong emotions. Call a supportive friend or family member. If you don’t have someone in mind that is supportive, call a helpline (for example, in the U.S. you can call the National Suicide Hotline at 1-800-273-TALK).
4. Do Something— Engage in a highly engaging activity. Television or computer activities do not count here -- these are too passive. Instead, take a walk, dance, clean your house, or do some other activity that gets you engaged and distracts you from your current emotions.
5. Ground Yourself— When emotions seem to be taking you out of the current moment (e.g., you are starting to feel “zoned out” or can’t see anything else going on at the moment), do something to ground yourself. Grab an ice cube and hold it in your hand for a few moments, snap a rubber band against your wrist, “snap yourself back” into the moment.
6. Help Someone Else— Do something nice for someone else. It doesn't have to be something big; you can walk to the nearest store, buy a pack of gum, and give the cashier a smile and say "have a great day." It may sound silly, but small gestures like this can really reduce emotional pain.
7. Play Music— Play music that creates an emotion that is the opposite of the one you are struggling with. For example, if you are feeling very sad, play happy, upbeat music. If you are feeling anxious, play slow, relaxing music.
8. Pray— Are you a religious or spiritual person? If you are (or even if you’re not but have considered trying), praying can be tremendously helpful in times of extreme stress.
9. Ride It Out— The peak of most strong emotional reactions (and the urges to engage in harmful activities, like self-harming or drinking, that can go along with these reactions) last for a few minutes and then begin to subside. Grab an egg timer from the kitchen, and set it for 10 minutes. Wait the 10 minutes, and practice riding out the emotion.
10. Take a Warm Bath or Shower— Try to lose yourself in the sensations of the warm water, the smell of the soap, etc. Allow the sensations to distract you from the situation you are upset about.

What is Mindfulness Meditation?

Mindfulness meditation has been defined in many ways, but perhaps one of the most widely-used definitions comes from Jon Kabat-Zinn, Ph.D., (the creator of a treatment for stress and chronic pain called “Mindfulness-Based Stress Reduction”), who defines mindfulness as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”

When you practice mindfulness meditation, you practice being in the present moment, and noticing all of your experiences. You practice being aware of things happening outside of yourself (e.g., things you see, smell, hear), and things happening internally (e.g., your thoughts, feelings and sensations). Importantly, mindfulness meditation involves being aware without judgment. So, you are paying attention to all of these experiences, without labeling them as good or bad.

Mindfulness is a concept that comes from the Buddhist spiritual tradition. For almost almost 3,000 years, Buddhist monks have practiced mindfulness meditation -- but in recent years mindfulness practice has become increasingly widespread and applied outside of the Buddhism. In fact, most Eastern practitioners who use mindfulness think of it as a skill that can be used separately from any kind of religious or spiritual practice. So, no matter what your religious background, mindfulness meditation may be helpful for you.

What Does Mindfulness Meditation Have to Do With BORDERLINE PERSONALITY DISORDER?

Marsha Linehan, Ph.D., who created Dialectical Behavior Therapy for BORDERLINE PERSONALITY DISORDER was one of the first to apply mindfulness meditation training to the recovery of BORDERLINE PERSONALITY DISORDER. Often, individuals with BORDERLINE PERSONALITY DISORDER not only experience intense emotions, they can become “stuck” in these emotions and judge both the emotions and themselves (e.g., “This is a terrible feeling and I am such a weak person for feeling this way”).

Unfortunately, this can end up making the emotion feel even more intense. And, judgmental thoughts can add other emotions to the mix — if you tell yourself you are weak for feeling sad you may end up feeling both sad and ashamed.

Mindfulness meditation training can help individuals with BORDERLINE PERSONALITY DISORDER to feel less “stuck” in their emotions, and less judgmental of the emotions and themselves. Mindfulness meditation training may also help individuals with BORDERLINE PERSONALITY DISORDER be more effective in applying healthy recovery strategies in the midst of emotional pain, because mindfulness skills allow you to get just a little bit of space to be able to notice the emotion and be more strategic in terms of how you will act in the face of the emotion.

For example, imagine being in a verbal argument with someone you love. During the argument you may feel very intense feelings, such as anger, fear and rage. Without mindfulness skills, you are more likely to act on these feelings without being able to see the consequences -- maybe you yell at your loved one, throw something or storm out. With mindfulness meditation practice, you may be able to notice the emotions you are having (e.g., you may think to yourself “I’m feeling really angry, hurt, and afraid right now”), and you may be able to step back and chose your behavior (e.g., “I am too upset to talk about this and I am may say or do something I’ll regret later. I need to take a time out from this discussion”).

How to Practice Mindfulness Meditation—

There are a variety of ways to begin practicing mindfulness meditation. Usually you can begin practicing mindfulness by trying some exercises that promote mindfulness.

Self-Help Emotional Processing and Expression—

Some individuals find that processing or expressing emotions on their own can be a very useful way to engage in self-help. For example, some individuals write in a journal or blog, others draw or paint -- and some find other creative, healthy ways to express their emotions. There is some research that suggests that expressive writing, for example, can have a variety of positive consequences, including better physical health and reduced psychological symptoms.

It is important to note that for some individuals, engaging in these types of strategies can feel overwhelming or triggering. If you feel you do not have the recovery strategies needed to manage the emotions that come from emotional processing activities, then you probably need to start with some recovery strategies training. However, if you and your therapist think you are ready to try emotional processing exercises, you may find that writing in a journal can be a good place to start.

1 comment:

Anonymous said...

Hi Mark,
Not sure how I feel...............Psych has diagnosed 17year old with Aspergers and Borderline. She has previously been diagnosed with Aspergers and two doctors said 'something else as well' . This doctor seems really steady and has seen our daughter quite few times before diagnosis. Eliza is OK about it - her 24 year old sister has borderline. I feel responsible, reading WHY children end up with a diagnosis of borderline.
We have recently been parenting using your help with difficult children. It has made a huge difference. Eliza now lives back home and is conforming to expectations. This program has taught my husband and I a lot about parenting. We are all much happier. I do feel sad about diagnosis.

Regards.
Heather

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