Thursday, 5 November 2020

Best The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells By Randi Kreger

Best The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells By Randi Kreger

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The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells-Randi Kreger

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Gentle counsel and realistic advice for families contending with one of today's most misunderstood forms of mental illness.For family members of people with Borderline Personality Disorder (BPD), home life is routinely unpredictable and frequently unbearable. Extreme mood swings, impulsive behaviors, unfair blaming and criticism, and suicidal tendencies--common conduct among those who suffer from the disorder--leave family members feeling confused, hurt, and helpless. In Stop Walking on Eggshells, Randi Kreger's pioneering first book which sold more than 340,000 copies, she and co-author Paul T. Mason outlined the fundamental differences in the way that people with BPD relate to the world. Now, with The Essential Family Guide to Borderline Personality Disorder, Kreger takes readers to the next level by offering them five straightforward tools to organize their thinking, learn specific skills, and focus on what they need to do to get off the emotional rollercoaster: (1) Take care of yourself; (2) Uncover what keeps you feeling stuck; (3) Communicate to be heard; (4) Set limits with love; and (5) Reinforce the right behaviors. Together the steps provide a clear-cut system designed to help friends and family reduce stress, improve their relationship with their borderline loved one, improve their problem-solving skills and minimize conflict, and feel more self-assured about setting limits.

Book The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells Review :



PART 1 -- WHAT IS BORDERLINE PERSONALITY DISORDER?The word "Borderline" is an old reference to someone who was on the "border" between neurotic and psychotic. BPDs experience intense emotions that are out of proportion to the stressful event. BPDs usually express their anger with intense rage. BPDs feel unworthy, like they are never "good enough." The most con-current disorder with BPD is depression. "Splitting" is when the BPD sees someone as their champion (idealization) and also as someone out to get them (devaluation). Adolescents with BPD may be "cutters". Indications that they might be cutting themselves include wearing long-sleeve shirts, spending too much time in the shower, increasing substance abuse, isolating themselves after a stressful event, and hoarding sharp instruments.HOW DO BPDs THINK?They experience their feelings as facts.They jump to negative conclusions without any supporting facts.They assume others are thinking poorly of them.They catastrophize, thinking that something is far worse than it really is.They blame others while being held accountable for nothing.They quietly are self-critical while repelling compliments.They lie or blow the truth out of proportion.WHAT IS A HIGHER-FUNCTIONING BPD?They disavow having any problems, always blaming their spouse. They refuse to go to counseling unless they are threatened to go. Then, they try to convince the therapist they are being victimized.They hide their low self-esteem behind a confident pose. They function well at work and only display aggressive behavior toward those close to them.A SPOUSE WITH BPD WILL......argue like a young child argues....not be aware of his or her own emotions....overreact to either real or imagined rejection....be aggressively destructive to either self or others.THE NON-BPD SPOUSE WILL......always be blamed for any marital problems....often describes a "damned-if-I-do" and "damned-if-I-don't" experience when their BPD spouse reacts negatively to however the non-BPD spouse behaves....be pushed away by their BPD spouse when they get too close, and then accused of abandoning them when they back off.RISK FACTORS OF BPDThe limbic part of our brain controls our emotions.A person who has too many or too few neurotransmitters could be at risk for BPD.A fault-finding parent, or one who invalidates their child's feelings, or one who is too overwhelmed to meet their child's needs could put their child at risk for BPD.TREATING BPD WITH MEDICATIONSMedications cannot cure BPD, but they can reduce BPD symptoms such as depression, mood swings, dissociation, aggression, and impulsivity by normalizing the brain's neurotransmitter levels. The goal with medications is to use the lowest dose which alleviates the symptoms while minimizing the side effects. Clients should know the side effects of stopping a medication before doing so.THERAPIES FOR BPDCognitive-behavioral therapy is the thought-feeling-action approach used throughout this book.Dialectical-Behavioral Therapy means that BPDs must learn to do two opposite things: accept themselves, and yet not stay the way they are, but acquire new skills. The primary objective of doing couples therapy where one spouse has BPD is to improve the couple's communication skills.FINDING PROFESSIONAL HELPBPDs are one of the most difficult disorders to treat because......lower functioning BPDs come to therapy with a defeatist attitude, thinking that they cannot get better....BPD patients are often hostile, verbally attacking their therapists....high-functioning BPD spouses will usually accuse their non-BPD spouses of having BPD and being abusive, unreasonable, controlling.When searching for a therapist, you should ask these questions:Do you believe that both medications and Dialectical-Behavioral Therapy are necessary in treating someone with BPD?Do you have experience in treating borderline clients? If yes, how long have you been doing so?Do you keep informed of the latest BPD research?A good therapist will......avoid getting pulled into their BPD clients' misery....assess how well each BPD client can manage their emotions....accentuate the client's strengths and successes, like taking note of the days the BPD does NOT fall apart emotionally.PART 2 -- HOW TO HELP A PERSON WITH BPDSELF-CARETo help your family member who has BPD, you must help yourself first.It takes only one person to fundamentally change a relationship.You don't need cooperation from the BPD for your life to improve.Do not let yourself be embarrassed into isolation or pushed into it by threats, implied or outright. Reach out to others.Find a therapist for you.Take things less personally.Learn to control your worry, guilt, anger, and low self-esteem.WHAT IT MEANS TO ACCEPT YOUR LOVED ONE WITH BPDYou acknowledge that you didn't cause your loved one's BPD behavior, you cannot control it, and you cannot cure it. You live in the present, you no longer dwell on the negative past. You accept that the worst may happen. After you do, you start to see what good you actually have.REDUCE YOUR STRESS BY......breathing deeply from one's stomach (diaphragm)....getting 1 to 1 1/2 hours more sleep each night....exercising regularly.BE CAREFUL OF THE "STOCKHOLM SYNDROME"...making excuses for the BPD abuser's behavior, such as "He was abused as a child."...rewarding the BPD abuser with small tokens of kindness for NOT being abusive when abusiveness was expected....becoming preoccupied with the needs, desires, and habits of the BPD abuser in an effort to prevent the BPD from having an outburst....adult children of BPDs who have low self-esteem often try to relieve their shame by being good.Rescuing the BPD does not work because it prevents BPDs from experiencing the consequences of their own behavior, thus enabling them to act irresponsibly. Elizabeth B. Brown, author of Living Successfully with Screwed-Up People, says there is a way to sincerely help people without rescuing them. She suggests the following support messages:I'm here for you, but there are limits and boundaries.I'm here for you, but I know that your choices and their consequences belong to you.THE SPLITTING-SHAME-FEAR SPIRALThe BPD processes information differently than the non-BPD. When the BPD sees a threat, their emotions hijack their brain. They craft insults from general remarks, pull negative intent out of thin air, and twist innocent phrases into daggers. They interpret their own fear as anger. They then can become aggressive, and start an all-out fight over the smallest thing.The author recommends the following responses to this spiral:Instead of trying to show the BPD that her beliefs are wrong, the non-BPD should say to the BPD that they both care for one another, that they can be a team together, and that they both want love and intimacy, and they want at least to be in the same room together without hostility. The non-BPD should remind himself that his BPD spouse is talking aggressively because she is scared, not because her scathing accusations are true. The non-BPD should truly practice deep breathing at the beginning of a BPD's rage.WHAT A NON-BPD SPOUSE SHOULD SAY WHEN THE BPD SPOUSE BEGINS A VERBAL TIRADE"I want to hear what you have to say, but it's hard for me when things get too emotional.""We'll talk later when things calm down.""We'll talk later when I can give you my full attention."THEY SHOULD NOT SAY"You need to calm down and be reasonable. You're getting out of hand."WHEN AMBUSHED AND YOU FORGET WHAT TO SAY, REMEMBER THESE FOUR THINGS1. Breathe deeply.2. Stay safe. Leave or call for help if necessary.3. Keep your eyes soft and steady. Relax your face. Keep your arms uncrossed.4. Empathize with the BPD's feelings even if you don't agree with her words. Keep your tone of voice neutral.WHAT "INTENTIONAL COMMUNICATION" MEANSIt is possible to empathetically acknowledge a BPD's emotions without agreeing with their thinking.It is good to ask clarifying questions such as, "What can I do to help you right now?"Don't defend yourself when you are criticized.The author says, "People with anorexia don't eat enough, people with depression cry, people with rapid-cycling bipolar disorder are moody, and people with BPD yell."What the author means is that BPDs act this way because they have impulsive, excessive, and inappropriate anger. So don't take their anger personally.If a non-BPD spouse is in a car with their BPD spouse, and the BPD starts yelling, what should the non-BPD say?"I understand you're upset right now. Can we talk about this when we get home so I can give you my full attention?""I need some time to think about what you have just said. Can we talk about this when we get back home?"I do want to hear what you have to say but I'm distracted by traffic right now. Can we talk about this later?"If the non-BPD is driving, he should not say, "I'm going to pull over onto the side of the road until you stop yelling."NON-COMBATIVE STATEMENTS WHICH HELP DIFFUSE THE SITUATION"I might not be making myself very clear. What I'm saying is...""I'd like to stay focused on this one issue right now and not bring other subjects into the discussion.""Maybe we can work together to find a compromise on this subject."A COMBATIVE STATEMENT WOULD BE"You have a problem with yelling instead of discussing things calmly.""Stop being so emotional."EFFECTIVE WAYS FOR THE NON-BPD TO SET LIMITS FOR THE BPD"I won't stand here and listen to you yell at me, so I'm going to leave the room if this continues.""I won't tolerate that kind of language, so I'm going to leave the room if it continues.""Name-calling is not going to get us anywhere. If it continues, we'll have to discuss this another time."AN INEFFECTIVE STATEMENT FOR SETTING LIMITS"Stop acting like a child by throwing another temper tantrum."SETTING LIMITS REQUIRES THE NON-BPD TO......not concentrate on your BPD's personality flaws....not make decisions based on your fear of losing the relationship, or out of obligation or guilt....trust your own perceptions instead of listening to your BPD's negative, angry, and inaccurate judgments about who you are. Don't believe your BPD when, after you have set limits, they call you "selfish", "controlling", or "abusive."...not rescue your BPD from your limits, but let him take responsibility for how he reacts to your limits. He is accountable for his own emotions, actions, and choices.D.E.A.R. COMMUNICATION FOR SETTING LIMITS FOR THE BPDDescribe the situation as you see it in a factual, unemotional manner.Express your feelings or opinions about the situation clearly.Assert your limits, making them simple.Reinforce the benefits of your limits, if appropriate.Don't get pulled into arguments about your limits. Let go of your compelling need to make your BPD agree with you. Don't over-explain why you are setting limits.Be gentle so as to validate your BPD's feelings, yet be assertive so as to stand firm by your limits.Don't raise your voice. Use a gentle and calming tone.Use positive self-talk to offset negatives from the BPD.OTHER TOOLS FOR RESPONDING EFFECTIVELY TO BPD BEHAVIORUse the least reinforcing scenario (LRS) when your BPD makes an unpleasant comment. Stand still and remain expressionless.When visiting a family member with BPD, take someone with you, especially if the BPD member does not act out when other people are around.Praise the BPD's good behavior.EXAMPLES OF SETTING LIMITS WITH EFFECTIVE COMMUNICATIONSharon and her 29-year-old daughter, Amanda, who has BPD, have developed a communication system that compensates for the deficits of the disorder. It includes"Amanda, I need to talk to you about something. It may be upsetting to you, but in the long run things are going to work out okay.""I'm feeling overwhelmed by this conversation. I'm going to take a walk and calm myself down.""Let's do something else for a while so that we can let this all settle in. Then we'll talk some more."A non-BPD husband has set a limit for his BPD wife not to call him at work more than 2 or 3 times each day. The husband says to his wife,"We can talk when I get home. I won't feel so frustrated because I will be able to work, and you will feel less frustrated because I won't have to tell you I can't talk."Karen told her daughter with BPD, Angela, that she could not call her at her work more than 3 times each day unless it was an emergency. If Angela does not keep this limit, what is the best way for Karen to respond to her when Angela calls her a fourth time?Once she hears Angela's voice a fourth time, Karen should immediately say in a neutral tone, "We'll talk when I get home tonight," and then gently terminate the phone call. Or, if Karen is screening her calls, she should not pick it up when she sees that Angela is calling her.ENDORSEMENTSThis book has been endorsed by a number of professionals, before it went to publication, including:Dr. Robert Freidel, Distinguished Clinical Professor of Psychiatry at Virginia Commonweath University;Dr. Blaise Aguirre, medical director of the Adolescent Dialectical Behavioral Therapy Center at McLean Hospital;Dr Jim Breiling, from the National Institute of Mental Health;Dr. John Gunderson, Prof of Psychiatry at Harvard Medical School;Dr. Debra Resnick, a specialist in Dailectical Behaviorial Therapy:Dr. Freda Friedman, a DBT therapist.
This book is well written but dangerous for non-BPs with abusive BPs. I read it cover to cover and had to put a warning here for non-BPs. I have tried the techniques and they do not work if your BP is abusive and will only trap you in an unsafe escalation. In spite of frequently referencing Walking on Eggshells and having a clear knowledge that BPs can be volatile and abusive at times not once in the book does she present the option of leaving and creating a drain-free and happy life. A non BP does not have to stay on an environment where they are constantly yelled at, belittled or abused and it is not the non BPs responsibility to depersonalise constant character attacks. Kreger's mantra is to depersonalise and desensitise to cope with BPD rages but this is a a ticket to the non BP losing themselves and their dream of a safe and peaceful life. Many non BPs who chose BPs as partners grew up with a BP parent and have been fine tuned to sacrifice and serve the whims and moods of others and in my pov the non BP would be far better served by getting therapy on how to be more self assertive and it be totally ok to say a loud and clear no without constant depersonalising or care taking of the BPs emotions to stay safe. I liked the first half of the book and it's a good outline of life and relationships with a BP but the second half is dangerous and is the kind of advice that causes a Non BP to suffer and also to do things that can provoke domestic violence. I hope Kreger revises this book and gives clear options for the Non BP that leaving is always an option. Life is short and it is the non BPs right to create a peaceful life and home without being yelled at and punished repeatedly. I hope this review helps someone who feels stuck to know that their are more options than just depersonalising and desensitising and that it is ok for you to leave your BP just do it safely with support if they are domestically violent!

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