{February 28, 2015}   Struggling, breaking, hating

Struggling this morning. Woke up with a cold fist wrapped around my heart, straight through the breastbone, aching, and no matter of tossing and turning could alleviate that all it wanted to do was rip my heart out. It’s been 2 hours and I can still feel the pain. The dread of leaving the house and going to work is numbing and crushing all at once. Fell like I am walking to guillotine. I’m pepping myself to know that once I get there I can submerge and it will be fine till evening. But I open my emails and and the triggers are strong, just want to scream, leave, crawl back in that bed, pull that fist back into my heart. I hate. You know that I hate, I hate this.


I have one hour to put the face and the smile on. Talk the talk, ignore the pounding and coursing of fear, and pretend it’s all ok till I come home. Deal with the ever present trigger that will not go the fuck away, how long do we need to do this, I am not human, not normal, not OK, and I will break of you do not leave me alone.

{February 28, 2015}   Maybe…

Couldn’t have said it better myself. Thanks.

Between Yesterday and Today

Maybe, when we are at our lowest and feel as though we have nothing to say, is exactly when we have the most to say.  Maybe, we are afraid of being dismissed, talked down to, disrespected or diminished. Maybe, we are afraid of being shamed, wronged, laughed at or criticized. Maybe, we fear that our feelings will be invalidated or we will be condemned for having them.  Maybe, our feelings and thoughts were met with love, empathy and compassion at one time, but somewhere down the road, that person used those same feelings as weapons to hurt us. Maybe, it is a combination of these fears that prevent us from speaking our mind, talking about our feelings and sharing what is bothering us. It is my belief that we can only have these fears if this has been our experience when we have opened up and bared our souls to someone. How many…

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{February 27, 2015}   The Hulk

Haven’t written in a while, nothing seems to have changed, the waves of apathy and dread of waking up every morning still persist. It’s not that it’s not OK, it’s OK, I know what it feels like and at times it’s crazy overwhelming and I have to talk myself down on what the heck is the point and just head down and plough away. When I am busy and can just tunnel through, you can call it happy, someone asked me that today, was I happy? It’s not happy, it’s oblivion, and oblivion makes me “happy”.

That’s the fact with BPD, it keeps wanting to crawl up and consume you, and its the best when distracted. When my mind is so focused it doesn’t give anything the chance to leak in, and so I go full tilt and while I am in it, it feels great, I’ve locked out the insidiousness. But, it doesn’t go away and I know that, I still need to face the reckoning, the headmaster with the stick eventually. Sometimes I keep going full tilt so that the noise never starts but we all know how that ends, its not about drowning the beast, its managing the beast and if I ignore it, and me for too long, the crash comes.

So, I’ve been hop scotching through, the mornings and evenings are the worst. Morning because I wake up without defences up and its a whallop so hard across the face, literally staring death in the face. Evenings I’m tired and I don’t feel like tic tac to so I let it win and all the gruesome thoughts are in technicolor. I don’t even want to watch TV, my eyes are tired, my brain is tired but it numbs out the thoughts, till I turn the TV off and lie in bed watching my own psychological murder mystery in my head. Excepting there’s no mystery in who dies in the end or whodunit.

I don’t want to get mad at people’s ignorance, but I do get mad. I work with someone that is like the trigger to the beast, feeding morsels of meat to the lion in agonizing slow chunks, I just want to reach out and claw her head off. Seriously, the world of grey was meant for her, nothing is absolute, nothing is certain, everything is slow, ponderous and never ending, it’s a BPD nightmare of cloudy grey an waiting waiting waiting. My world is BLACK & WHITE, just get it done, stop poking the beast because the beast is going to bite.

This is where I chide myself on not getting angry at ignorance, because, it’s not her fault she works in a fashion that makes my BPD sing. No matter how I approach the subject  it’s like banging my head into the cloudy wall, nothing changes. So, I try and ignore her but I can’t because she holds too many pieces that pertain to my job. The days we work together, I try to stay so busy that there is no time to talk because I’m on the verge of having a mania where word vomit takes over and inside voice will become outside voice and then there will really be no grey.

The conundrum is, the longer this goes, the more build up and resentment is filling in me, and I’ve been tamping, shovelling and tucking it about, but it’s not fixing anything, and every email, every conversation is like a mini trigger that I have to take and quell and then hold my breath and wonder when the next is. I feel like a changeling, all good and then she hits and I can feel the scales growing, the tail forking and my eyes slitting and I’m this tongue flicking beast ready, tensed, willing myself not to pounce, that the prey will slowly go away and I can resume my non-hulk form. Really, that is who I feel like, The Hulk, I am trying so hard like Dr whatever his name is but enough provocation and no matter how he tried that big green monster’s going to come out and bash a hole through someone’s head, plus a few buildings in between.

This really cannot be what life is all about. It’s so purposeless. Does anyone think I want to be doing anything I do when I wake up every morning. I’m just living. Step by step, day by day. Just for you and you and you, not me.

Which made me think, what would I want to do that would make getting up everyday purposeful. Definitely not living here. Travel. I just want to travel, keep changing, keep moving, keep it different, occupied, fascinating. Nothing stays the same, its dynamic places, new faces, risk, lots of risk, just put it out there and whatever happens happens. This, this is monotony, it’s boring places, peoples, things, it’s a staid city with closed up people. I live in a city that everyone lauds but under the surface it  filled with cold and boring people all stuffed up in themselves and their rights, wrongs and conventions. People here are so confined and conservative, the Vatican would be more exciting.

{February 18, 2015}   It Feels Like Death in Here

Wake up every morning feeling like I’m fighting death himself, right inside my chest, a vortex that wants to suck the soul out of me. It’s not the most pleasant way to begin your day. Waking up wrapped in a shroud  and finding a way out of your own coffin,  through the dirt and into the shower, away from death. It takes an hour of mental gymnastics where I wonder for more than the millionth time, why am I doing this. After the first hour, the pang and longing to give in passes but the perma-fog beneath the plastic smile still wafts insidiously behind me all day.  The voices championing the cause of what’s the point, why are you putting yourself through this? How much easier, HOW MUCH easier to let it go, instead of all this useless shit.

It’s wheel of fortune, grim reaper style, round and round that wheel goes and every stop takes a tiny little bit of mental currency away till you can’t tell what phrase you’re meant to guess. Does it say live? life? Pull the little card and you have all the usual suspects, no $32,000 or trip to Bora Bora here.

a. jump off the building

b. take the pills

c. commit yourself

d. run off the damn road

e. pick up that knife

It’s not fun, neither is wearing the happy smile all day in public when all you want to do is shut the noise, shut the people, shut the fake, shut the fake shit right up. Because at the end of the day, carrying that smile, skip and jump all day feels like the weight of the world when you come back to desolation. And you sit in your apartment, alone, wondering, why did I just do that, did I do that for me because right now all it did was make me feel like the biggest piece of nothing in the world. I just gave and gave and gave all that fake happy energy so I could… be happy? I didn’t leave the house to make me happy. Wrong answer because happy didn’t come up on the board.

It’s like I’ve swallowed the bitter pill but instead of a pill it’s a rock and it’s stuck in my craw and not moving, and through the day it aches and hurts and pulls and tugs and I just want to tell someone to stick their head in their ass and fucking leave me alone because you just don’t know what I am going through to be here, to talk to you, to smile at you, to listen to all your stupid platitudes.

So, I’ve done this, everyday for the last few weeks, it’s been worse than normal but I’m fighting the fight, sucking it up, making all those people, clients, bosses, friends around me happy. Doing it for my kids. Then the 2 months before that, well, that was a different battle. I’ve numbed out those months of hateful, abandoned, sadness, pressure, loss for self preservation. Last thing I need is another black out.

So, here I am, survivor. Fighting, strong, walking beside death like we’re buddies. Knife twisted in my side, smile on my face. Wish I could be proud of all this strength, if only I knew why I was hurting myself so much to do this everyday… everyday. Looking forward to tomorrow morning.

{February 14, 2015}   My Wife is not her BPD (excerpt)

Excerpted from : Healing from BPD, please click link and read comment from Rowan and readers

I was so moved to read this beautiful love-letter of a post by Rowan about his experience of his wife, Aeshe, who he so eloquently describes while discussing his own, very real experience as a partner of someone with Borderline Personality Disorder.  Read on, and be moved as I was. Welcome my guest blogger, Rowan.

On: Supporting my wife, who has borderline personality disorder (BPD)

I feel like I am betraying my wife by writing this, even though I logically know this is not the case.  When Debbie asked me to write about supporting a loved one with Borderline Personality Disorder(BPD), as a companion to my vlog post on YouTube, I was immediately afflicted by the dueling emotions of relief and guilt.  I was relieved I would get another opportunity to share my perspective on loving a spouse with a mental illness, one stigmatized by popular media and the psychiatric community alike.  I felt guilty because, although Aeshe (my wife) is open about her struggles and healing from BPD, she still feels shame and anxiety about even having this diagnosis.

She worries about the judgment of others, the loss of friendships, the limiting of her options by deciding to be transparent about her life.  Even though I believe myself to be balanced and open in my assertions (not assessments) about what is so for me—when maintaining that difficult balance of being a supportive partner and maintaining my own health and wellness—I also desire to shield her from harm and hurt.  However, maintaining silence about my experience dealing with my wife’s BPD has only made me feel isolated and unseen, while making myself responsible for “protecting” her from the world does not acknowledge her as the dynamic and amazing woman I know her to be.

I met my wife in the early Winter of 2010, and we became friends and lovers in February 2011.  Aeshe’s BPD symptoms became apparent to me in early spring of last year (2012).  Though she’d previously had many diagnoses in the past, there was never one that officially stated “borderline personality disorder,” though many of the markers were there.  At first, I felt like I was thrown headlong into a maelstrom of interpersonal chaos, and couldn’t make sense of the emotional volatility I was witnessing.  Aeshe had impulsivity with food and spending, she became easily emotionally dysregulated seemingly apropos of minor situations, she was angry, she had difficulties being separated from me if I went to work, her dissociation became more pronounced, and she started self-harming again (i.e. after not having done so for a while).  I made the decision, with my eyes wide open, to support her and commit myself to our relationship.  We married on August 27, 2012, the day after my birthday.  I do not regret that decision, despite the inherent challenges of loving someone with BPD.

What followed was an intense crash course in BPD and interpersonal dynamics in the face of the criteria/symptoms she was displaying.  My hardest lesson was learning to de-escalate the situation.  My initial reaction to what I considered my wife’s intense and extreme emotional outbursts and rage was ineffective.  I am someone who takes responsibility for his own actions and, sometimes to my detriment, the actions and reactions of others.  I also have a minor savior complex.  Consequently, I became frustrated; I thought her reactions were all my fault, that if I just tried hard not to “set off” her emotional arousal everything would eventually settle.  Instead, my emotions fed off her emotions, which fed off my emotions, turning into an escalating ouroborous of dysregulation.  I tried pleading with and cajoling my Aeshe, pointed out how her reactions were irrational and not based in reality…which fanned her frustration and anger because she felt invalidated.

Eventually, through conscious and honest talks with Aeshe, and with the aid of processing and reading on my own, I developed the necessary skills to better support the both of us as she works on her recovery from BPD.  The following lessons have been very helpful to me:

  1. Consciously remind yourself that you have not caused your loved one’s dysregulation or their personal triggers.  You are only responsible for your own emotional states and reactions.
  2. Validate how they’re feeling, because emotions are not logical. Sometimes, expressing interest through a statement of concern—“It seems like you’re frightened.  That must be difficult for you right now”—is ample.
  3. Gracefully remove yourself from a situation if the both of you are unable to control your emotions.  Make sure your loved one knows you are not abandoning them, but calming down.
  4. Practice healthy selfishness, and partake in self-care. If you are not well-rested, hydrated, fed, and have your emotional needs met (e.g. a good support system for you is also helpful), you will not be happy.  This will, in turn, affect your relationship with your loved one.
  5. Try to interpret your loved one’s reactions in the most benign way possible.  People have accused those with BPD of being manipulative in their relationships.  Instead, they are trying frantically to defuse fear of abandonment.

I have myriad thoughts and impressions about my experience living with my wife, Aeshe.  I’ve learned so many valuable lessons about the nature of inner strength, what it means to support and love someone unconditionally, how to be authentic and vulnerable without being weak, and how to recognize my own emotional challenges and deal with them.  Since accepting and working with my wife’s BPD, I have come to recognize my diagnosis of Generalized Anxiety Disorder (GAD), and am taking steps to alleviate these symptoms and poor coping strategies that have plagued me for as long as I can recall. There’s more to express than just this brief snapshot revealing my general thoughts about maintaining balance when loving someone with BPD.

Here’s the crux of my life with Aeshe: She is NOT her disorder. BPD is just a component of her identity, though one that touches all aspects of our life together.  Every relationship and every life led has its unique set of challenges and heartaches, triumphs and joys.  Honestly, I cannot imagine being with someone more loving and compassionate, intelligent and quirky, beautiful and sexy.  She makes me question everything I know, inspires me to be a better person, and loves me unconditionally.  It doesn’t get better than that.

{February 14, 2015}   Alone in this BPD mind

My counsellor asked me yesterday if I was suicidal. Yes, I want to to die, with all my might right now, it is all I want to do BUT I’m not going to. I am suicidal, can I control it. Yes.

Power, someone said I wanted power, that I was on a power trip. It was such a ludicrous thought I realized that person knew nothing about me. Power? I barely can find the days to quit hating myself and wanting to die to bother finding power. I want the power to end it all without putting others in pain, that’s the power that I want. To be let go without the guilt. All these other things I do to live, does anyone truly think I want any of life? Life with BPD is being ruled by one big power trip you can barely control. Jump off that building without ruining my children’s lives, that’s the power I want.

There are days, like now, where to feel good about myself I need to read about myself, to know that what I feel is not isolated, that it is disease. That it cannot be logically fixed and solved. I read about me so I feel better that I am not alone and though I feel achingly alone, there are other people, like me, in pain, aching, just wanting the world to swallow them up, reading.

Loneliness and Lack of Self Worth 

Many people with BPD are isolated from conventional family or friendship situations.  As many people around them do not know how to cope with the sufferers behaviour, they tend to withdraw from their friend or relative.  This leads the person with BPD to feel lonely and worthless.  They already have a very low self-esteem and this makes it worse.  People with BPD are like anyone else, they want to feel loved, but in their case it is more extreme.  Left alone for too long and they believe nobody wants them.  This is mainly caused by rejection at a young age, it is learnt behaviour.  The self-loathing and fear of abandonment also causes loneliness.


Have you ever felt out of control?  Maybe you have felt like you are in a tunnel, no fear or thought of safety for yourself or other.  Detachment from reality, at times, can be how be how someone with BPD feels.  Often they suffer from intrusive thoughts or hear voices.  The only way to describe how it feels to have intrusive thoughts or hear voices is, imagine someone is with you 24 hours a day, imagine this person is saying things like “hurt yourself,” or “the devil is following you, he will take people away from you.”  Often the thoughts or voices will play on the sufferers insecurities.  Some people have other hallucinations or believe they have super powers.  Commonly people with BPD only have mild psychosis but occasionally some sufferers have more severe psychosis.  Mostly they only have psychotic episodes induced by stress.  Think about it, if you go to a party and everyone around you is drunk, and you do not like it, you would remove yourself from the situation, right?  In the BPD sufferers situation, the brain is removing it’s self from the problem which is the persons thinking and thoughts.

Depression, Self Harm and Suicide

Everyone goes through periods where they feel down or depressed.  But for a BPD sufferer it is like that very much of the time.  Also severe depression will flood them from time to time.   How often do you wish you were not alive any more?  Maybe once in your life but most likely it hasn’t ever crossed your mind.  A majority of people with BPD think about it very regularly.  In fact for a BPD sufferer it becomes normal and it can be quite a surprise to them when someone tells them they never think of it.

Have you ever been in so much emotional pain that you’d do anything to relieve it?  Trying to counter act the emotional pain with physical pain is logical if you think about.  It’s like tooth ache, you’d do anything to relieve it.  So one of the reasons a sufferer self-harms if to get some relief.  Another cause for self-harm in a BPD sufferer is self-loathing, they feel so bad about themselves that they feel they need to be punished.  Self-harm is not always a sign of a suicide attempt, it’s just a reflection of how the person is feeling on the inside.

Threats of suicide are common among people with BPD, and it’s also not uncommon for them to make an attempt at ending their life.  Life with Borderline Personality Disorder is ten times harder than for a non-sufferer. Imagine how the constant fear and pain must be.  Suicide threats are like a safety net, “If I really can’t stand my pain any more, then I can escape,” makes sense doesn’t?  If you walked through a bed of stinging nettles you would think of trying to get yourself out wouldn’t you?

Withdrawal from Others

Many people with BPD have times when they withdraw from the world.  They stop working and socialising.  If you were hurt by something you would try and avoid letting it happen again, wouldn’t you?  So this can be why someone with BPD may become distant and unresponsive to friends and family.  In most cases this withdrawal doesn’t last for more then a few days, weeks or months, but in some sufferers it can last much longer.  When withdrawn the sufferer will feel depressed and isolated.

{February 14, 2015}   You Don’t Own Me

I met with my counsellor yesterday and had a great session.

She was very positive about my coming off my daytime meds, Wellbutrin and Cipralex. She was horrified at how bad the withdrawal must have been. Oh yes, it was hell on earth and she was the only person that actually clued in how painful withdrawal was after being on medication for over 14 years. I was with someone at the time, they didn’t notice.

We discussed, why am I working for a bunch of people who don’t appreciate me, invalidate me, second guess me and then disbelieve me. I have not had a positive word in 10 months just what I should do, should not do, why am i doing, how to do, where to do and don’t believe you. Sounds fun right?

My counsellor advises I need to stop worrying about them and what they think of me and set my boundaries and limits. If the stress and pressure don’t change after XX (I am supposed to figure out what is a good timeline to give myself to see change) I have to take a deep breath and walk away. It’s hard to walk, I feel obligated but more than that I love the business, I just hate how its being handled right now and it makes me unhappy. Corporate brains trying to smash a round peg into a square hole, me included, never going to happen, not sure they’ll ever figure that out. But, its my baby and I care about all the people who work there, and they’d be devastated if I left, probably leave too, which would be dismal all around. I feel like I have a responsibility to the brand, the previous owner and what we built from nothing. The new owners say everything is crap, but this tiny, new store went from a nothing to the best in the city carrying the best names in the business. It didn’t happen with a spreadsheet, it happened with hard work, intuition, talent, creativity and people that believed in you. I don’t have the desire to work for people who don’t believe me.

I think I just said it (damn I love writing).

I don’t want to work for people who don’t believe in me. I also don’t feel the need to prove myself. I proved myself in this industry long before these people came in to re-invent the wheel.

{February 9, 2015}   Wishing for Help & Understanding

I excerpted this from the National Education Alliance for BPD. I have read it many times like a child looks at a jar of candy. I wish I had all of the below. Everything below is like a big hot fudge sundae, I want it so bad.

1. Remember that change is difficult to achieve and fraught with fears. Be cautious about suggesting that “great” progress has been made or giving “You can do it” reassurances. Progress evokes fears of abandonment.

The families of people with Borderline Personality Disorder can tell countless stories of instances in which their son or daughter went into crisis just as that person was beginning to function better or to take on more responsibility. The coupling of improvement with a relapse is confusing and frustrating but has a logic to it. When people make progress – by working, leaving day treatment, helping in the home, diminishing self-destructive behaviors, or living alone- they are becoming more independent. They run the risk that those around them who have been supportive, concerned, and protective will pull away, concluding that their work is done. The supplies of emotional and financial assistance may soon dry up, leaving the person to fend for herself in the world.

When signs of progress appear, family members can reduce the risk of relapse by not showing too much excitement about the progress and by cautioning the individual to move slowly. This is why experienced members of a hospital staff tell borderline patients during discharge not that they feel confident about their prospects, but that they know the patient will confront many hard problems ahead. While it is important to acknowledge progress with a pat on the back, it is meanwhile necessary to convey understanding that progress is very difficult to achieve. It does not mean that the person has overcome her emotional struggles. You can do this by avoiding statements such as, “You’ve made great progress,” or, “I’m so impressed with the change in you.” Such messages imply that you think they are well or over their prior problems. Even statements of reassurance such as, “That wasn’t so hard,” or, “I knew you could do it,” suggest that you minimize their struggle. A message such as, “Your progress shows real effort. You’ve worked hard. I’m pleased that you were able to do it, but I’m worried that this is all too stressful for you,” can be more empathic and less risky.

2. Lower your expectations. Set realistic goals that are attainable. Solve big problems in small steps. Work on one thing at a time. “Big”, long-term goals lead to discouragement and failure.

Although the person with BPD may have many obvious strengths such as intelligence, ambition, good looks, and artistic talent, she nonetheless is handicapped by severe emotional vulnerabilities as she sets about making use of those talents. Usually the person with BPD and her family members have aspirations based upon these strengths. The patient or her family may push for return to college, graduate school, or a training program that will prepare her for financial independence. Family members may wish to have the patient move into her own apartment and care for herself more independently. Fueled by such high ambitions, a person with BPD will take a large step forward at a time. She may insist upon returning to college full time despite undergoing recent hospitalizations, for example. Of course, such grand plans do not consider the individual’s handicaps of affect dyscontrol, black and white thinking, and intolerance of aloneness. The first handicap may mean that, in the example given, the B received on the first exam could lead to an inappropriate display of anger if it was thought to be unfair, to a self-destructive act if it was felt to be a total failure, or severe anxiety if it was believed that success in school would lead to decreased parental concern. The overriding issue about success in the vocational arena is the threat of independence —much desired but fraught with fear of abandonment. The result of too large a step forward all at once is often a crashing swing in the opposite direction, like the swing of a pendulum. The person often relapses to a regressed state and may even require hospitalization.

A major task for families is to slow down the pace at which they or the patient seeks to achieve goals. By slowing down, they prevent the sharp swings of the pendulum as described and prevent experiences of failure that are blows to the individual’s self-confidence. By lowering expectations and setting small goals to be achieved step by step, patients and families have greater chances of success without relapse. Goals must be realistic. For example, the person who left college mid-semester after becoming depressed and suicidal under the pressure most likely could not return to college full time a few months later and expect success. A more realistic goal is for that person to try one course at a time while she is stabilizing. Goals must be achieved in small steps. The person with BPD who has always lived with her parents might not be able to move straight from her parents’ home. The plan can be broken down into smaller steps in which she first moves to a halfway house, and then into a supervised apartment. Only after she has achieved some stability in those settings should she take the major step of living alone.

Goals should not only be broken down into steps but they should be taken on one step at a time. For example, if the patient and the family have goals for both the completion of school and independent living, it may be wisest to work on only one of the two goals at a time.


3. Keep things cool and calm. Appreciation is normal. Tone it down. Disagreement is normal. Tone it down, too.

This guideline is a reminder of the central message of our educational program: The person with BPD is handicapped in his ability to tolerate stress in relationships (i.e., rejection, criticism, disagreements) and can, therefore, benefit from a cool, calm home environment. It is vital to keep in mind the extent to which people with BPD struggle emotionally each day. While their internal experience can be difficult to convey, we explain it by summarizing into three handicaps: affect dyscontrol, intolerance of aloneness, and black and white thinking. To review:

Affect Dyscontrol:

A person with BPD has feelings that dramatically fluctuate in the course of each day and that are particularly intense. These emotions, or affects, often hit hard. We have all experienced such intense feelings at times. Take for example the sensation of pounding heart and dread that you may feel when you suddenly realize that you have made a mistake at work that might be very costly or embarrassing to your business. The person with BPD feels such intense emotion on a regular basis. Most people can soothe themselves through such emotional experiences by telling themselves that they will find a way to compensate for the mistake or reminding themselves that it is only human to make mistakes. The person with BPD lacks that ability to soothe herself. An example can also be drawn from family conflict. We have all had moments in which we feel rage towards the people we love. We typically calm ourselves in such situations by devising a plan for having a heart-to-heart talk with the family member or by deciding to let things blow over. The person with BPD again feels such rage in its full intensity and without being able to soothe himself through the use of coping strategies. It results in an inappropriate expression of hostility or by acting out of feelings (drinking or cutting).

Intolerance of Aloneness:

A person with BPD typically feels desperate at the prospect of any separation – a family member’s or therapist’s vacation, break up of a romance, or departure of a friend. While most of us would probably miss the absent family member, therapist or friend, the person with BPD typically feels intense panic. She is unable to conjure up images of the absent person to soothe herself. She cannot tell herself, “That person really cares about me and will be back again to help me.” Her memory fails her. She only feels soothed and cared for by the other person when that person is present. Thus, the other person’s absence is experienced as abandonment. She may even keep these painful thoughts and feelings out of mind by using a defense mechanism called dissociation. This consists of a bizarre and disturbing feeling of being unreal or separate from one’s body.

Black & White Thinking (Dichotomous Thinking):

Along with extremes of emotion come extremes in thinking.

This review of the handicaps of people with BPD is a reminder that they have a significantly impaired ability to tolerate stress. Therefore, the family members can help them achieve stability by creating a cool, calm home environment. This means slowing down and taking a deep breath when crises arise rather than reacting with great emotion. It means setting smaller goals for the person with BPD so as to diminish the pressure she is experiencing. It means communicating when you are calm and in a manner that is calm. It does not mean sweeping disappointments and disagreements under the rug by avoiding discussion of them. It does mean that conflict needs to be addressed in a cool but direct manner without use of put-downs. Subsequent guidelines will provide methods for communicating in this fashion.

4. Maintain family routines as much as possible. Stay in touch with family and friends. There’s more to life than problems, so don’t give up the good times.

Often, when a member of the family has a severe mental illness, everyone in the family can become isolated as a result. The handling of the problems can absorb much time and energy. People often stay away from friends to hide a problem they feel as stigmatizing and shameful. The result of this isolation can be only anger and tension. Everyone needs friends, parties, and vacations to relax and unwind. By making a point of having good times, everyone can cool down and approach life’s problems with improved perspective. The home environment will naturally be cooler. So you should have good times not only for your own sake, but for the sake of the whole family.

5. Find time to talk. Chats about light or neutral matters are helpful. Schedule times for this if you need to.

Too often, when family members are in conflict with one another or are burdened by the management of severe emotional problems, they forget to take time out to talk about matters other than illness. Such discussions are valuable for many reasons. The person with BPD often devotes all her time and energy to her illness by going to multiple therapies each week, by attending day treatment, etc. The result is that she misses opportunities to explore and utilize the variety of talents and interests she has. Her sense of self is typically weak and may be weakened further by this total focus on problems and the attention devoted to her being ill. When the family members take time to talk about matters unrelated to illness, they encourage and acknowledge the healthier aspects of her identity and the development of new interests. Such discussions also lighten the tension between family members by introducing some humor and distraction. Thus, they help you to follow guideline #3.

Some families never talk in this way, and to do so may seem unnatural and uncomfortable at first. There may be a hundred reasons why there is no opportunity for such communication. Families need to make the time. The time can be scheduled in advance and posted on the refrigerator door. For example, everyone may agree to eat dinner together a few times a week with an agreement that there will be no discussions of problems and conflict at these times. Eventually, the discussions can become habit and scheduling will no longer be necessary.


6. Don’t get defensive in the face of accusations and criticisms. However unfair, say little and don’t fight. Allow yourself to be hurt. Admit to whatever is true in the criticisms.

When people who love each other get angry at each other, they may hurl heavy insults in a fit of rage. This is especially true for people with BPD because they tend to feel a great deal of anger. The natural response to criticism that feels unfair is to defend oneself. But, as anyone who has ever tried to defend oneself in such a situation knows, defending yourself doesn’t work. A person who is enraged is not able to think through an alternative perspective in a cool, rational fashion. Attempts to defend oneself only fuel the fire. Essentially, defensiveness suggests that you believe the other person’s anger is unwarranted, a message that leads to greater rage. Given that a person who is expressing rage with words is not posing threat of physical danger to herself or others, it is wisest to simply listen without arguing.

What that individual wants most is to be heard. Of course, listening without arguing means getting hurt because it is very painful to recognize that someone you love could feel so wronged by you. Sometimes the accusations hurt because they seem to be so frankly false and unfair. Other times, they may hurt because they contain some kernel of truth. If you feel that there is some truth in what you’re hearing, admit it with a statement such as, “I think you’re on to something. I can see that I’ve hurt you and I’m sorry.”

Remember that such anger is part of the problem for people with BPD. It may be that she was born with a very aggressive nature. The anger may represent one side of her feelings which can rapidly reverse. (See discussion of black and white thinking.) Keeping these points in mind can help you to avoid taking the anger personally.

7. Self-destructive acts or threats require attention. Don’t ignore. Don’t panic. It’s good to know. Do not keep secrets about this. Talk about it openly with your family member and make sure professionals know.

There are many ways in which the person with BPD and her family members may see trouble approaching. Threats and hints of self-destructiveness may include a variety of provocative behaviors. The person may speak of wanting to kill herself. She may become isolative. She may superficially scratch herself. Some parents have noticed that their daughters shave their head and color their hair neon at times when they are in distress. More commonly, what will be evident is not eating or reckless behavior. Sometimes the evidence is blunt – a suicide gesture made in the parent’s presence. Trouble may be anticipated when separations or vacations occur.

When families see the signs of trouble they may be reluctant to address them. Sometimes the person with BPD will insist that her family “butt out.” She may appeal to her right to privacy. Other times, family members dread speaking directly about a problem because the discussion may be difficult. They may fear that they would cause a problem where there might not be one by “putting ideas into someone’s head”. In fact, families fear for their daughter’s safety in these situations because they know their daughters well and know the warning signs of trouble from experience. Problems are not created by asking questions. By addressing provocative behaviors and triggers in advance, family members can help to avert further trouble. People with BPD often have difficulty talking about their feelings and instead tend to act on them in destructive ways. Therefore, addressing a problem openly by inquiring with one’s daughter or speaking to her therapist helps her to deal with her feelings using words rather than actions.

Privacy is, of course, a great concern when one is dealing with an adult. However, the competing value in these situations of impending danger is safety. When making difficult decisions about whether to call your loved one’s therapist about a concern or call an ambulance, one must weight concern for safety against concern for privacy. Most people would agree that safety comes first. There may be a temptation to under-react in order to protect the individual’s privacy. At the same time, there may be a temptation to overreact in ways that give the person reinforcement for her behavior. One young woman with BPD told her mother excitedly during an ambulance ride to a psychiatric hospital, “I’ve never been in an ambulance before!” Families must apply judgment to their individual situation. Therapists can be helpful in anticipating crises and establishing plans that fit the individual family’s needs.

8. Listen. People need to have their negative feelings heard. Don’t say, “It isn’t so.” Don’t try to make the feelings go away. Using words to express fear, loneliness, inadequacy, anger, or needs is good. It’s better to use words than to act out on feelings.

When feelings are expressed openly, they can be painful to hear. A daughter may tell her parents that she feels abandoned or unloved by them. A parent may tell his child that he’s at the end of his rope with frustration. Listening is the best way to help an emotional person to cool off. People appreciate being heard and having their feelings acknowledged. This does not mean that you have to agree. Let’s look at the methods for listening. One method is to remain silent while looking interested and concerned. You may ask some questions to convey your interest. For example, one may ask, “How long have you felt this way?” or “What happened that triggered your feelings?” Notice that these gestures and questions imply interest but not agreement. Another method of listening is to make statements expressing what you believe you’ve heard. With these statements, you prove that you are actually hearing what the other person is saying. For example, if your daughter tells you she feels like you don’t love her, you can say, even as you are contemplating how ridiculous that belief is, “You feel like I don’t love you?!?” When a child is telling her parents that she feels as if she has been treated unfairly by them, parents may respond, “You feel cheated, huh?” Notice once again, these empathic statements do not imply agreement.

Do not rush to argue with your family member about her feelings or talk her out of her feelings. As we said above, such arguing can be fruitless and frustrating to the person who wants to be heard. Remember, even when it may feel difficult to acknowledge feelings that you believe have no basis in reality, it pays to reward such expression. It is good for people, especially individuals with BPD, to put their feelings into words, no matter how much those feelings are based on distortions. If people find the verbal expression of their feelings to be rewarding, they are less likely to act out on feelings in destructive ways.

Feelings of being lonely, different, and inadequate need to be heard. By hearing them and demonstrating that you have heard them using the methods described above, you help the individual to feel a little less lonely and isolated. Such feelings are a common, everyday experience for people with BPD. Parents usually do not know and often do not want to believe that their daughter feels these ways. The feelings become a bit less painful once they are shared.

Family members may be quick to try to talk someone out of such feelings by arguing and denying the feelings. Such arguments are quite frustrating and disappointing to the person expressing the feelings. If the feelings are denied when they are expressed verbally, the individual may need to act on them in order to get her message across.


9. When solving a family member’s problems, ALWAYS:

a) involve the family member in identifying what needs to be done
b) ask whether the person can “do” what’s needed in the solution
c) ask whether they want you to help them “do” what’s needed

Problems are best tackled through open discussion in the family. Everyone needs to be part of the discussion. People are most likely to do their part when they are asked for their participation and their views about the solution are respected. It is important to ask each family member whether he or she feels able to do the steps called for in the planned solution.

By asking, you show recognition of how difficult the task may be for the other person. This goes hand in hand with acknowledging the difficulty of changing.

You may feel a powerful urge to step in and help another family member. Your help may be appreciated or may be an unwanted intrusion. By asking if your help is wanted before you step in, your assistance is much less likely to be resented.

Mental health suffers from a major image problem. One in every four people experiences mental health issues — yet more than 40 percent of countries worldwide have no mental health policy. Across the board it seems like we have no idea how to talk about it respectfully and responsibly.

Stigma and discrimination are the two biggest obstacles to a productive public dialogue about mental health; indeed, the problem seems to be largely one of communication. So we asked seven mental health experts: How should we talk about mental health? How can informed and sensitive people do it right – and how can the media do it responsibly?

End the stigma

Easier said than done, of course. Says journalist Andrew Solomon: “People still think that it’s shameful if they have a mental illness. They think it shows personal weakness. They think it shows a failing. If it’s their children who have mental illness, they think it reflects their failure as parents.” This self-inflicted stigma can make it difficult for people to speak about even their own mental health problems. According to neuroscientist Sarah Caddick, this is because when someone points to his wrist to tell you it’s broken, you can easily understand the problem, but that’s not the case when the issue is with the three-pound mass hidden inside someone’s skull. “The minute you start talking about your mind, people get very anxious, because we associate that with being who we are, fundamentally with ‘us’ — us as a person, us as an individual, our thoughts, our fears, our hopes, our aspirations, our everything.” Says mental health care advocate Vikram Patel, “Feeling miserable could in fact be seen as part of you or an extension of your social world, and applying a biomedical label is not always something that everyone with depression, for example, is comfortable with.” Banishing the stigma attached to mental health issues can go a long way to facilitating genuinely useful conversations.

Avoid correlations between criminality and mental illness

People are too quick to dole out judgments on people who experience mental health problems, grouping them together when isolated incidents of violence or crime occur. Says Caddick, “You get a major incident like Columbine or Virginia Tech and then the media asks, ‘Why didn’t people know that he was bipolar?’ ‘Was he schizophrenic?’ From there, some people think, ‘Well, everybody with bipolar disease is likely to go out and shoot down a whole bunch of people in a school,’ or, ‘People who are schizophrenics shouldn’t be out on the street.’” Solomon agrees that this correlation works against a productive conversation about mental health: “The tendency to connect people’s crimes to mental illness diagnoses that are not in fact associated with criminality needs to go away. ‘This person murdered everyone because he was depressed.’ You think, yes, you could sort of indicate here this person was depressed and he murdered everyone, but most people who are depressed do not murder everyone.”

But do correlate more between mental illness and suicide

According to the National Institute for Mental Health (NIMH), 90 percent of people who die by suicide have depression or other mental disorders, or substance-abuse disorders in conjunction with other mental disorders. Yet we don’t give this link its due. Says Solomon, “Just as the association between mental illness and crime is too strong, the connection between mental illness and suicide is too weak. So I feel like what I constantly read in the articles is that ‘so-and-so killed himself because his business had gone bankrupt and his wife had left him.’ And I think, okay, those were the triggering circumstances, but he killed himself because he suffered from a mental illness that drove him to kill himself. He was terribly depressed.”

Avoid words like “crazy” or “psycho”

Not surprisingly, nearly all the mental health experts we consulted were quick to decry playground slang like “mental,” “schizo,” “crazy,” “loonie,” or “nutter,” stigmatizing words that become embedded in people’s minds from a young age. NIMH Director Thomas Insel takes that one step further — he doesn’t like the category of “mental health problems” in general. He says, “Should we call cancer a ‘cell cycle problem’? Calling serious mental illness a ‘behavioral health problem’ is like calling cancer a ‘pain problem.’” Comedian Ruby Wax, however, has a different point of view: “I call people that are mentally disturbed, you know, I say they’re crazy. I think in the right tone, that’s not the problem. Let’s not get caught in the minutiae of it.”

If you feel comfortable talking about your own experience with mental health, by all means, do so

Self-advocacy can be very powerful. It reaches people who are going through similar experiences as well as the general public. Solomon believes that people equipped to share their experiences should do so: “The most moving letter I ever received in a way was one that was only a sentence long, and it came from someone who didn’t sign his name. He just wrote me a postcard and said, ‘I was going to kill myself, but I read your book and changed my mind.’ And really, I thought, okay, if nobody else ever reads anything I’ve written, I’ve done some good in the world. It’s very important just to keep writing about these things, because I think there’s a trickle-down effect, and that the vocabulary that goes into serious books actually makes its way into the common experience — at least a little bit of it does — and makes it easier to talk about all of these things.” SolomonWax, as well as Temple Grandin, below, have all become public figures for mental health advocacy through sharing their own experiences.

Don’t define a person by his/her mental illnesses

Just as a tumor need not define a person, the same goes for mental illness. Although the line between mental health and the “rest” of a person is somewhat blurry, experts say the distinction is necessary. Says Insel: “We need to talk about mental disorders the way we talk about other medical disorders. We generally don’t let having a medical illness define a person’s identity, yet we are very cautious about revealing mental illness because it will somehow define a person’s competence or even suggest dangerousness.” Caddick agrees: “There’s a lot of things that go on in the brain, and just because one thing goes wrong doesn’t mean that everything’s going wrong.”

Separate the person from the problem

Continuing from the last, Insel and Patel both recommend avoiding language that identifies people only by their mental health problems. Says Insel, speak of “someone with schizophrenia,” not “the schizophrenic.” (Although, he points out, people with autism do often ask to be referred to as “autistic.”) Making this distinction clear, says Patel, honors and respects the individual. “What you’re really saying is, this is something that’s not part of a person; it’s something the person is suffering from or is living with, and it’s a different thing from the person.”

Sometimes the problem isn’t that we’re using the wrong words, but that we’re not talking at all

Sometimes it just starts with speaking up. In Solomon’s words: “Wittgenstein said, ‘All I know is what I have words for.’ And I think that if you don’t have the words for it, you can’t explain to somebody else what your need is. To some degree, you can’t even explain to yourself what your need is. And so you can’t get better.” But, as suicide prevention advocate Chris Le knows well, there are challenges to talking about suicide and depression. Organizations aiming to raise awareness about depression and suicide have to wrangle with suicide contagion, or copycat suicides that can be sparked by media attention, especially in young people. Le, though, feels strongly that promoting dialogue ultimately helps. One simple solution, he says, is to keep it personal: “Reach out to your friends. If you’re down, talk to somebody, because remember that one time that your friend was down, and you talked to them, and they felt a little better? So reach out, support people, talk about your emotions and get comfortable with them.”

Recognize the amazing contributions of people with mental health differences

Says autism activist Temple Grandin: “If it weren’t for a little bit of autism, we wouldn’t have any phones to talk on.” She describes the tech community as filled with autistic pioneers. “Einstein definitely was; he had no language until age three. How about Steve Jobs? I’ll only mention the dead ones by name. The live ones, you’ll have to look them up on the Internet.” Of depression, Grandin says: “The organizations involved with depression need to be emphasizing how many really creative people, people whose books we love, whose movies we love, their arts, have had a lot of problems with depression. See, a little bit of those genetics makes you sensitive, makes you emotional, makes you sensitive — and that makes you creative in a certain way.”

Humor helps

Humor, some say, is the best medicine for your brain. Says comedian Wax: “If you surround [your message] with comedy, you have an entrée into their psyche. People love novelty, so for me it’s sort of foreplay: I’m softening them up, and then you can deliver as dark as you want. But if you whine, if you whine about being a woman or being black, good luck. Everybody smells it. But it’s true. People are liberated by laughing at themselves.”

{February 9, 2015}   Reality BItes

Reality, it’s being picked up by your feet and swung into a concrete wall. I am back in reality and it feels worse than when I left, struggling to hold down tears and nausea as hurt, pain, guilt, sadness and revulsion pours out from that hole inside of me that was neatly put away the last 4 days with being accepted and believed, all faults included.

It’s back to being the animal in the cage that no one understands, poked at, ridiculed and hurt. With no voice or anyone nearby to touch, hug or crawl into when needing empathy, like right now, it’s a huge void of emptiness. Going to have to find the reserves to make do with one therapy appointment a month to be open and maybe even get a genuine hug of validation.

I pep talked myself on the plane and last night, just suck it up, do what you’re asked and when you can, get out, leave town, find the nurture, just god damn do it no matter what anyone says. Find the happy people or the happy place if it means leaving every 3 months and no one here understanding, try and not let them get to me. Invalidation. They don’t understand, do not expect them to understand and last of all, do not expect them to empathize. It’s a battle field, and the only way to survive it to tuck in, stay with the inner strength. Being alone is better than  being lonely with people or reaching out and getting slapped.

I need to remember they can’t see past the outside, so if they see smiles and sociability, to them you are-OK.

et cetera
A Forgetful Traveler

Remembering the world one blog post at a time

Life after BPD

Life after Borderline Personality Disorder; making a life worth living through love, laughter, positivity and Dialectical Behaviour Therapy

Bi-polar parenting

Thoughts and ideas

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