The Setup Setback: Abandonment and Impulsiveness issues with Borderline Personality Disorder

Do those of us with Borderline Personality Disorder tend to act or behave in ways that set us up for our worst fear: abandonment?  This post explores this question with my own personal example.

As some of my Twitter and Facebook followers know, I have been going through a stressful ordeal. And while I can't get into all of the details (they aren't really necessary to illustrate this anyway), I believe I experienced something this morning that many others with BPD can relate to.  I myself have noticed this pattern within my own life, and while I am working super duper hard at Dialectical Behavior Therapy (DBT) to build a life worth living and to not act in impulsive ways that make the situation worse and that I'll later regret, I am only human, and I'm not perfect.

In addition to not being perfect and being a human being, with BPD, I experience my emotions much more intensely, sometimes with sudden onset, especially with emotions such as anger and anxiety. 

While these days I usually have enough of my Wise Mind available to slow things down and be mindful by putting space between the initial thought or emotion and any action I take, this is not the case 100% of the time. This morning, I did not think about the potential long-term or even immediate short-term effects of my actions -- I only did what would make me feel better in that moment. 

And, when I do act impulsively, I nearly immediately feel remorseful and regretful for my behavior, wondering how I could not have possibly slowed things down in order to avoid yet another fiasco due to emotion dysregulation.

This post is not about me now bashing myself for the error or being intolerant with the reality that, as well as I am doing, and as much as I practice my DBT skills, there will be times when I don't live up to the goals I set for myself around my recovery.

I acted impulsively and did not carefully consider how my actions would directly affect the one person in my life who is really there for me right now and standing by my side. Now he's angry, which is very difficult for me to tolerate.

I wonder how much of this was a subconscious pattern, now revealed in the light of retrospect, that I engage in to push people away during difficult times. I've described a similar event before as a preemptive strike -- I'm afraid you might abandon/leave/reject me, so I'll act in a way that is so horrible and upsetting to you that you actually do, and we get it over with.

Sound familiar?

I am upset right now, as I must live with the consequences of relieving myself of anxiety by acting out on an impulse and not slowing things down. Hardly seems worth it now, but all I can do now is damage control and engaging in skills that will help me to not only feel less distressed but to also help me to prevent myself from making matters even worse and more distressful.

I'll be digging into my Distress Tolerance skills. In particular:

  • Distracting with activities:  I've barely left the house since I've been working from home. I need to get out of my pajamas, put some makeup on, and go somewhere. Anywhere. The grocery store to get something to make dinner would be a great start.
  • Self-soothing:
    • Vision: I think a ride to the ocean to see the shore and smell the salty air is in order. When I get back home, I'll light my candle that smells like the seaside.
    • Hearing: Time for Enya.
  • Improve the Moment: 
    • Vacation: Immersing myself in a good TV show or two or a movie

Every moment is a choice. I choose to stop myself in my tracks, slow down, and improve the situation as much as I can.

Thanks for reading.
More Soon.

"Re-Wiring" our Nervous System's Reaction to Stress and Trauma (using Dialectical Behavior Therapy)

This week in the Distress Tolerance DBT (Dialectical Behavior Therapy) group that I attend, our therapist/group leader spoke about the interesting ways in which our nervous systems have been conditioned and thus affect our present responses and reactions to stress.

I learned that our nervous systems have adapted to react to stressful situations based on past experiences. In a word, they become "activated" to go into action based on past traumas.

For example, when I was a child, my father had a very terrible temper and could fly off of the handle at any moment and become abusive. Because of that, to this day, I am very sensitive to men becoming angry -- even without my being aware of it in the moment, I can later look in retrospect and see that I respond in ways that allow me to protect myself physically and emotionally, based on automatic thoughts that my brain and nervous system generate in such situations, based on past trauma. But what about when these gut reactions are overreactions to current, non-threatening situations?

The good news is, according to my therapist, we can override some of these reactions that no longer serve us.  There are many reactions and responses that I have come to notice over the years in DBT - reactions to stress and upsets that may have worked as a child or a teen but that no longer serve me as an adult trying to navigate this world with Borderline Personality Disorder.

As I continue to work on building a life worth living - a key component to DBT according to its creator, Dr. Marsha Linehan, I look for ways to grow into the person that I want to become. Part of that plan is to be a mentally stable, competent, and happy adult. It's working!
When we let go of our old, no longer useful ways of coping, and as we learn and integrate new behaviors and skills, I liken it to a snake shedding it's skin and starting with entirely new tools.

As we undergo these changes, let's remember that our initial, usual reactions do have cause. Our initial reactions of anger, fear, etc. all served us at one point and likely kept us safe or feeling safe.  By remembering that there is cause for our initial reactions, we can more easily let go of the judgment that something is terribly wrong with us for our reactions.  We can choose to change our reactions by learning and consistently practicing our DBT skills.

We can also minimize additional distress through our new found strength.  One of the main purposes of Distress Tolerance skills is to help us to learn to tolerate distress without making our situation worse. Now that's definitely a part of building a life worth living!

Thanks for reading.
More soon.

Getting Skillful and Avoiding a Crisis Using DBT (Dialectical Behavior Therapy)

More DBT for Me:

My therapist and I recently agreed to add a second weekly DBT (Dialectical Behavior Therapy) group to my treatment plan while I am going through a few very stressful issues simultaneously.

The module that I am now attending (in addition to the full DBT course) is Distress Tolerance. Distress Tolerance skills are intended to help you get through a crisis situation without making your situation work. In essence, you practice skills that help you tolerate the distress.

I attended today, and while I became emotional when it was my turn to process, I am glad that this resource is available to me.  I was able to hear how other people are dealing with difficult stressors effectively (and not so effectively), and I got to hear, out loud, how far I have come in terms of dealing with distress and intense emotions.

At the moment, while I can't go into specifics, I am dealing with sexual harassment at work, and it's not the first time.  As a result, I've been triggered and have been feeling very uncomfortable and stressed.

*Trigger Warning*

I found out from a colleague that while my boss was speaking about me, he blamed me for his inappropriate behavior. My colleague told him not to blame the victim. His response? You can blame the victim when she willingly walks into your trap.  

I don't think I want to know what he's saying anymore. Too triggering.

*End Trigger Warning*

My therapist and I agreed that, since I have the option to do so, my work for this employer should continue only from home.  That might sound like a dream come true for most people -- and it is pretty great -- you get to manage your time much differently and work out your own hours that you are actually working during the day, but for me, there is also a down side.

Although I'd been given the option to work from home from the get-go, I soon realized that the depression creeping up on me was from being isolated and feeling lonely.  I also didn't do very well with a lack of imposed structure of any kind and not needing to get up and get dressed nicely for any reason. For these reasons, I voluntarily began going into work Monday through Friday for a few hours each day. I made friends with colleagues and felt like a part of the team, especially at meetings.

Since Monday, I've been working at home. I miss my coworkers very much and miss the routine of going to and being at work.  I'm getting my work done, but I find myself just wanting to go back to bed or to wake up really late.  I've been good about not doing either of these things, except for yesterday, when I took a nap, but when you don't have to commute or be somewhere during certain hours, the days can get pretty long -- plenty of time to fill.

As a person with Borderline Personality Disorder, boredom can also be incredibly distressing, so I am faced with needing to manage my time so that I get some socialization, don't oversleep, get my work done, and take care of myself.

I am facing a dialectic:

One part of me wants to be at work because of the stress and sadness I am experiencing as a result of the isolation from my colleagues, lack of structure, and tendency to oversleep.

Another part of me feels that I need to not be around my boss/the workplace for my own mental health safety.

Self-Care Plan:

In order to process through this, I am realizing that I don't have to completely isolate myself.  I am going to make plans with a colleague or two to meet outside of work for a meal or coffee - unfortunately I must tell them that I cannot discuss why I am not at work. Awkward.

In addition to performing my work remotely, I am also going back to yoga classes, and, as mentioned, increasing my DBT classes.   I will work on getting caught up on cleaning my house, and I will need to continue to come up with ways to fill my time.

DBT Skills I am using/will use:

  • LOTS of Self-Soothing, including:
    • soothing music 
    • guided meditations
    • yoga
    • swaddling in a blanket
  • Improving the Moment:
    • lighting a nicely scented candle
  • Distraction:
    • Fun TV shows
    • Pushing Away thoughts when they get to be too much (I imagine putting them in a box upon the shelf until I am ready to cope again.)
  • Wise Mind:

This is not easy, but I have the DBT Skills to pay the mental health bills. I mean - I have the skills to get through this. :)

Are you facing one or more intense situations in your life? How are you coping?

Thanks for reading.
More Soon.

Catastrophizing Alternatives for Emotionally Sensitive People

A common trait in those of us diagnosed with Borderline Personality Disorder (and those diagnosed with a number of anxiety disorders as well, for that matter) is a tendency to jump to the worst possible scenario when a problem arises.

We then often spend our time stressing and freaking out over the worst possible scenario that we can imagine as an outcome to our current problem or suffering, rather than dealing in this moment with the actual reality of what is happening now.

This is called catastrophizing.

Here are some examples:

  • Your boss is in a bad mood, so you jump to the conclusion that he must hate you, and you're going to be fired.
  • You have a cold, and you think you'll never get better.
  • You think that if you express how you really feel, the person will completely abandon you.
  • One thing goes wrong, and you're afraid everything in your life will then fall apart and you'll lose everything.
Fortunately, rarely in life is anything so clear cut, black or white, or all or nothing. There is a spectrum of possibilities - lots of shares of grey.

In BPD, we tend to, at least initially, see the two extremes on the spectrum. It may take some coaching and practice to begin to be mindful that there are other possibilities and options when we perceive things this way.

When we do begin to practice this reality, we can experience a sense of calm in knowing that the world is a little bit more flexible than we once thought.  We can realize that we are not stuck with only two polarizing options (dialectics). This can be a real relief.

Marsha Linehan, the founder of DBT (Dialectical Behavior Therapy), once spoke about a patient she had that suffered from chronic pain. The patient called Dr. Linehan and said that she thought the pain would go on forever and that she'd always be suffering.

Dr. Linehan suggested to the patient that she had enough suffering to deal with right now - in this very moment - why should she project herself into the future, which isn't even here yet, and suffer for that time, too?

Some DBT skills that can help with staying in this moment include:

Are there some areas in your life that you may be perceiving in a All or Nothing or Black or White terms? Is it possible to find some shades of grey? How might doing so reduce your suffering in the now?

Thanks for reading.
More Soon.

Altering Your Mood with Music (DBT: Opposite Action)

A reader on my Facebook page asked me an interesting question about emotional triggers yesterday. She asked if triggers, which are normally referenced in mental health discussions as things/stimuli that can bring up traumatic past experiences, can also call up "good" memories through listening to certain songs, smells, or sights that remind you of good times in your life.

I'm glad she brought this up, as this is absolutely the other side of what we commonly refer to as "triggers." We can be triggered into remembering pleasant memories just as we can be triggered into remembering the unpleasant ones.

One of the DBT (Dialectical Behavior Therapy) skills that we can use to help us with purposefully inducing a different state of mood or emotions is called "Opposite Action."  This skill is used when we wish to change the emotion we are currently experiencing, and we do so primarily through the senses.

For example, if you're feeling angry, and you want to feel calm, you would take an action that would help produce the desired emotion of calmness. In this case, you would select and listen to music that you know helps calm you down.

I've been very nostalgic lately about my later high school years. I've noticed that if I play certain music from that time period, I feel soothed and remember a simpler time in my life. Some of my favorite music that I listened to at that time (late 1990s) does the trick.

Last night, to do this, I fell asleep to Enya's Paint the Sky with Stars CD (highly recommended if you are soothed by pleasant, smooth, new age music). 

Here's are two songs (my favorites) off of that CD. If you need to relax, sit back, close your eyes, and enjoy this for a few moments.

Do you notice that music can have a profound effect on your moods? What has been your experience? What are some songs that soothe you? Some that get you out of an emotional funk?

Thanks for reading.
More Soon.

Inappropriate Anger Outbursts - Borderline Personality Disorder

I am shocked at what happened this afternoon. At my own behavior, really.

I had an angry outburst in the middle of a supermarket and looked my boyfriend in the eyes and said, in a hostile, cold voice: "F___ You!"  The visceral sensations (blood pressure rising, everything else around me fading) reminded me of a time over a decade ago, long before I was diagnosed with Borderline Personality Disorder and when I would feel very triggered by my former partner.

I would often lash out with intense angry outbursts, often behaving inappropriately in public places (causing scenes, swearing, throwing things, storming out.) I was "well known" where I used to live and was thought of as crazy.

The DSM (Diagnostical Statistical Manual of Psychiatric Criteria for Diagnosing BPD) describes this as:

"Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)."

For so long, "Angry Deb" has been nowhere to be found. I was so incredibly taken aback by my reaction and behavior. I was in control, but I let myself lose it in a way that I haven't in a very long time.

All these years later, with so much personal work done (and much more to go, of course), I knew, in that very second that the anger consumed me, that this was an old, familiar feeling.  

My boyfriend walked out of the store and did not want to talk to me. I chased after him, trying to apologize, but he didn't want to hear it. I realized that I really needed to go back into the store for the original purpose: to buy cat food. I walked back toward the store, following my breath. I called Wise Mind on board. 

As I did this, I was able to acknowledge that although I perceived my boyfriend as being insensitive by discussing things that he knows have been triggering to me in the past, my anger was grossly misdirected at him.

*Possible Trigger Warning*

The truth is, I have been sexually harassed at work by the same manager that did this to me five years ago. I never thought he would go there again, and he has. He even used the word "molest" in his conversation with me.  I have been dissociating ever since Friday when this, and other overtly sexual gestures were made to me.  I ended up taking it out on my boyfriend and having graphic thoughts of cutting.
                                                     *End Trigger Warning*

I knew immediately that I needed to calm down. I focused on the cans of cat food. I got into line and noticed details about the people in front of me and the cashier.

I paid for my order and engaged in small talk with the cashier.  As I walked out of the store, I felt the wind on my face. I knew that I had to be humble, apologize sincerely to my boyfriend and be completely honest that my anger was inappropriate and misdirected.  I shared with him that I hadn't felt this upset and angry in over a decade, and I talked with him about what happened at work.

I also filled out an Interpersonal Effectiveness Worksheet 1 DBT (Dialectical Behavior Therapy) form.  I wept. I sobbed. I took deep breaths.  My boyfriend forgave me and understood why I was behaving this way.  We both talked about my need to get skillful to cope with these issues.

I plan to:
  • Radically Accept that while I do not APPROVE of what happened on Friday, I do ACCEPT that it did happen and that I must respond like the adult that I am and deal with the situation appropriately.
  • Engage in self-care to soothe my nervous system over what has happened. This will include a hot shower, my favorite television shows, and listening to soothing music.  I am also debating on whether to take a mental health sick day tomorrow from work (I've emailed my boss today, confronting him on the incidents, by the way.)
  • Engage in mindful breathing and eating.
  • Get proper rest.
  • If I feel the anger coming on again, I will excuse myself and cry/scream/get it out in private.
  • Refer to my DBT binder and fill out worksheets as often as needed to stay grounded and mindful of my emotions and behaviors
  • Stop beating myself up over what has happened. Everything has cause. It wasn't right for me to behave the way I did, but I have figured it out, sincerely apologized and am taking every step not to repeat my behavior.

Emotions can surprise us sometimes. We can surprise ourselves by acknowledging them and responding in a skillful way - in a way that was not available to us before.

I am not the same Angry Deb from ten years ago. I am so much more aware of my states of emotions and much more resilient to incidents that take me off guard. 

More than anything, I have the skills to cope effectively with what has happened today and this past Friday, no matter how difficult it may be. For this, and for my boyfriend's ability to forgive and understand, I am grateful.

Thank you for reading.
More soon.

When News Stories Are Triggering | Using DBT to Recoup

Many of us with Borderline Personality Disorder also have symptoms of PTSD (Post Traumatic Stress Disorder).  Even if we do not, there may be certain subjects and circumstances that can "trigger" us into a troubled state, whether we flashback to the past or feel extremely frightened, as if we were in present danger even if we are not.

Because I am very sensitive to violence, I abstain from television shows and movies that I know contain it (except this one time recently, when I used bad judgment and ended up triggered). I also completely avoid the evening news.  

As careful as I am, because I am a talk radio junkie, I inevitably hear snippets of the news during the day. We can't completely avoid it. People around us will talk about it. We'll hear about it out in public. 

It's not that I want to live under a rock and not know what's going on in the world, but I find that knowing about senseless acts of violence where I have no control to help anybody does not do anything to help my mental state.

On the way to work today, I heard a snippet.

*Possible Trigger Warning*

Evidently, a young man in his twenties open fired on a bunch of moviegoers last night at the midnight showing of the new Batman movie in Denver, Colorado.  Twelve perished, mostly young children and their mothers, and about three dozen others remain critically wounded.

I was shocked, but what took me aback was the graphic description of one girl's experience and her tear-felt reaction caught on tape and played through my radio speakers. I won't repeat it. It's too much....tears streamed down my face, and I shouted "Why God?" I was angry and sad. My mind, unfortunately, "went there" doing a reenactment of the terrible scene as my mind imagines it must have happened. I felt shaken up.

I was actually driving on a road where I didn't have the option to pull over, so I quickly started noticing my breathing. I noticed my in-breaths and out-breaths. I focused on the road. I then knew I needed to distract, so I put on some upbeat music.  This all helped. 

There was nothing I could do, and I was already dealing with distress -- I was on my way to the opthamologist for an emergency eye appointment which also called for putting my DBT skills into overdrive. (I may blog on this in the next few days.)

After my eye appointment, since I couldn't drive or really use the computer due to my eyes being dilated, I went to work for a few hours. All I could really do was help fill in for our office manager (who was out sick) by answering the phone. I only answered one call, and you would not believe what happened.

I noticed on the display that the call came from Denver, Colorado. It was one of our vendors. I mentioned that we heard what had happened and that everyone there was on our hearts. The woman told me, in a shaky voice, that her dear friend is the downstairs neighbor of the shooter. She heard a song playing loudly on his apartment, and it was looped, playing over and over. She called the cops. They made the connection and entered the booby trapped apartment.

*End Trigger Warning*

Imagine - I don't normally answer the phone at the work place, and the ONE call I get is this one?  Sometimes I really stand back in wonder at the amazing "coincidences" that the Universe sets or allows up in our lives for learning lessons. I was able to listen and be supportive to this stranger who was so closely related to the tragedy I'd heard about on the radio this morning.

Wouldn't have been possible a year ago.

If you are also triggered by news stories, here is what I do to help myself through this type of trigger. I hope you will find something helpful.

  • Gently Avoid: I deliberately avoid watching the evening news and stations like CNN unless there is a story of interest that does not include graphic images, references, or audios relating to violence. If I hear something in passing, I change the television or radio station and quickly distract with an engaging activity.
  • Emotion Regulation (Empathy): If, like this morning, my emotional mind shows up and reacts to hearing the event (as would likely happen for many people, whether they have BPD or not), I tap into empathy and practice modulating the emotion. I use self-talk to remind myself of how human and normal it is to feel sadness for other people who have suffered or have been hurt.  I sometimes feel compelled to use the DBT skill of prayer to pray for those who were harmed and their loved ones and neighbors. (As a side note, I am not any particular religion and am open and accepting of everyone. My boyfriend, for example, is an atheist.)
  • Mindfulness Grounding: I notice my breath and follow it for a few minutes, then I begin noticing and describing sensations and surroundings. I notice my feet on my floor, the feeling of being supported by the chair, the plants in the room, the colors of the walls, etc. Doing this helps bring me back into the present moment, where all is well, and I am safe.

Are you also sensitive to the news or certain types of television shows and movies? What do you do to engage in self-care?

Thanks for reading.
More soon.

Crying Over Coleslaw | Everything Has "Cause" (Emotional Reactions to "Small Things")

According to Dr. Marsha Linehan, founder of DBT (Dialectical Behavior Therapy), designed to help those of us with Borderline Personality Disorder (and other mental illnesses):

 "Everything has cause."

By this she means that something happened before whatever is happening now, and if that event had been different, so would whatever is happening in this moment. 

Everything is part of a chain of events.  Sometimes it's clear to us what the cause of an emotion, mood, or circumstance is, and other times it is not. But even if we are not clear on what the cause was, there was indeed one (or many.)

In one of her videos,  From Chaos to Freedom, Dr. Linehan uses this (rather upsetting) example: 

*Possible Trigger Alert*

Dr. Linehan talks about a situation where a child on a bike is hit by a car at an intersection, and the child passes away.  Many people will say and believe things along the lines of, "That should NOT have happened! There was no reason for this!"

But, when the police check all the facts, they notice that the brakes weren't working very well on the child's bike and that a car raced through an intersection where there was no stop sign.  

So, whether we think it was fair, right, horrible, or unthinkable, Dr. Linehan says that due to all of the causes, this "should" have happened.  She tells us that this assessment is not a judgment of the incident that happened but just a factual look at cause and effect.

*End Trigger Alert*

As upsetting as this example is, and perhaps even because of it, I have remembered to consider that when I am feeling a certain way, there is, in fact, cause.

As I sat on my kitchen floor tonight literally crying and inconsolable over the fact that the grocery clerk had evidently forgotten to give me the coleslaw I had paid for and was desperately craving, I realized that the coleslaw was really not the issue.  My wise mind kicked in, and I knew that the coleslaw was just a "final straw" on a stack of other stressors that I've been experiencing lately.

There was "cause" for my crying at the frustration of the missing coleslaw, but I knew that my reaction was not in proportion to just this incident.  

I've been stressed over a number of things lately, including interpersonal issues at work, a slow down in available work due to the economy, my boyfriend's plans to finally pick a date to move back overseas, a friend being recently admitted to a psych ward, and trying to figure out what the best course of action is for my life with all of this going on.  

In addition, DBT group was cancelled again this week. This was frustrating because I look forward to the weekly appointment and find it's an important part of managing my symptoms.

It's not easy, and somehow, as I've done before, I thought that if I didn't acknowledge the pink elephant in the room (all of these things going on in my head), I could somehow outsmart the stress or maybe put off dealing with it all a bit longer.

In addition, I've noticed the following over the past few days:

☑ Moodiness
☑ Sugar Cravings
☑ Soothing with food
☑ Very irritable and wanting to be alone
☑ Tired
☑ Tense

All of  these combined are red flags that my body and mind were giving me that the need for self-care was imminent.  I'm so good at encouraging others to self-care, as I discuss in my recent video, and I'm usually good at walking the talk, but I've recently been letting things build up, and well, you know the rest.

So, I need a plan.  The first thing I will do is self-care tonight: a long, hot shower with pretty smelling soaps, watch a couple of upbeat shows on TV while wrapped in a snuggly blanket on the couch with my cats, perhaps a meditation CD or falling asleep to my favorite Enya CD, and radical acceptance that, even if it's just baby steps, I must face the issues that are happening in my life like an adult. 

Noticing, describing, and actually dealing with our problems - it's not always easy, but it is a part of building a life worth living.

Thanks for reading.
More Soon.

6 Ways To Get The MOST out of DBT (Dialectical Behavior Therapy)

1. Show Up

It sounds so simple, but it is, of course, essential. Some groups have specific attendance requirements, but it's a good idea to set a goal for yourself that no matter how you feel mentally on the day of group, you will show up.  In doing so, you'll be practicing the DBT skill of "opposite action," a skill that can transfer to other areas of your life and be very helpful for completing tasks when you "don't feel like it." It is also helpful for shifting moods or emotions that you want to change. I often find that on the days I least felt like showing up, I ended up getting the most out of the group.

2. Truly Participate in Mindfulness Opening: 

The first 5 minutes of DBT group (after settling in) is a five minute mindfulness meditation. Group leaders will often use a track from one of Marsha Linehan's (founder of DBT) CD, although sometimes other types of CDs are used.   Each exercise invites you to focus on JUST ONE THING, in the moment. For example, there is an exercise that asks you to sort your thoughts, called the Conveyor Belt exercise. Exercises like these can become resources to you in times of stress, episodes of dissociation (when you have "come back") and other times when you may feel overwhelmed with emotion.

3. Pay Attention:

It is so easy to get distracted by thoughts of what happened just before group or earlier in the day. It's also easy to think about what is happening after group, but for that time that you are present in group, it is important to be present not just physically, but also mentally.  I speak with fellow sufferers of Borderline Personality Disorder from around the world - many of them on waiting lists of over 2 years or who simply have no access to DBT. They would love to be in your place, so since you have a seat in class, be sure to value it. You are enrolled in a highly sought after, effective treatment to help you to discover who you really are and how you can begin to build a life worth living. 

Perhaps bring a bottle of water, sit up straight, and really listen to what others are saying. If you have something to contribute, considering doing so at the appropriate times. Taking notes can also help you stay focused, and that is the next tip.

4. Take Notes:

Taking notes is a great way to capture information that you think may be helpful for you to reflect on later. You can also put concepts into words that make more sense to you and jot down questions you may have for when there is time to ask. 

5. Do Your DBT Homework:

Most DBT leaders assign, in the least, Diary Cards for completion at home, and the group members are expected to complete these and bring them back to class. Diary Cards are a great way of documenting your success and challenges with using the skills you are learning on a daily basis.

Here is a blank Diary Card as well as a blog post on why I fill mine out, and a review of DBT Diary Card App available for iPhones and iPads.

I also offer FREE DBT Homework assistance every Wednesday night.

6. Participate in Examples:

During class, there are often opportunities for you to volunteer to share a bit about a particular struggle you are having, and the teacher may use the example on the dry erase board to illustrate how to use the skills to cope or deal with your specific issue. I find these opportunities invaluable and often volunteer for them.

What if DBT is not available to me?

First, make sure that's the case.  You might try an Online DBT Class.

Lots of my readers are self-teaching the DBT skills.  I've gathered a number of resources, including books, workbooks, DVDs, and more on the BPD Resources page of this blog. Be sure to check it out. I update it as I find new resources to add. 

Thank you for reading.
More Soon.

Goodbye Norma Jean | Did Marilyn Monroe have Borderline Personality Disorder?

Goodbye Norma Jean | Did Marilyn Monroe have Borderline Personality Disorder?
*Trigger Warning: This post contains frank discussion about the nature of American actress Marilyn Monroe's passing and her psychiatric suffering.  The post does come around to an encouraging end, but please use discretion and take care of yourself and your well-being.*
I have always adored Marilyn Monroe. I'm into retro movies, and she, Audrey Hepburn, and Rita Hayworth are my absolute favorite actresses from that time.  When I was a young girl, I would often hear Elton John's "Candle in The Wind," a song dedicated to the late Monroe, and while I enjoyed it,  I never really understood the meaning behind it.
I have recently started listening to an oldies station (60s, 70s, and yes - the 80s- are now considered "oldies!"), and Elton John is on frequent rotation. At least a couple of times a week, "Candle in the Wind" is played.  I've begun to really listen to the lyrics. Last week, when I heard the song for the first time in a while, I was moved to tears by the compassionate message that was written for such a troubled woman, but unfortunately all too late.
In the song, Elton sings, "Goodbye Norma Jean..."  Marilyn Monroe was born Norma Jean Mortenson (Baker) on June 1, 1926.   
According to, Norma Jean never knew her father's identity, and because her mother had serious psychological problems, there was no way she could raise her beautiful daughter. Her mother in fact, was committed to a mental institution.  Norma Jean lived out her childhood bouncing from foster home to foster home and to orphanages.
It has been said that those who knew her best felt that she always had a deep insecurity because of this -- she felt that she was unlovable and unwanted.  Growing up in such an invalidating environment no doubt affected her self-image and her views on life and the world in general.
As a young woman, she bounced from one tumultuous love affair to another, marrying quickly and repeatedly, and never finding the security that she so desperately hoped marriage would bring. She is also rumored to have had affairs with both President John F. Kennedy and his brother Robert (among others) shortly before her passing.


Also according to, it was Norma Jean's idea to create the character of "Marilyn Monroe," with a new name, new hair color, and a new personality.  She didn't want to be Norma Jean. Her decision to reinvent herself was a success. By 27 years of age, she was known around the world for her leading lady roles in a number of movies from the 1950s.While a wonderful accomplishment, this may have unfortunately also reinforced that she, herself (as Norma Jean), was not worth of the love and attention and success that she achieved as Marilyn. 
In many ways, she must have felt proud to have overcome such a troubled childhood to rise and shine as one of the brightest stars the world has ever known, but she was unhappy.
Her final film was never completed, as she was fired from the set for missing several days of filming that she attributed to "illness." The speculation is that she was suffering from intense psychological pain and did not have anyone that she trusted enough to reach out to hence the lyrics in Elton John's song, "It seems to me you lived your life like a candle in the wind...never knowing who to cling to, when the rain set in...."
According to Dr. Richard A. Moskovitz, author of the book "Lost in The Mirror: An Inside Look at Borderline Personality Disorder," Elton John's characterization of Marilyn Monroe as a candle in the wind captures the essence of the borderline personality. She is an elusive character lacking in identity, overwhelmed by a barrage of painful emotions, consumed by hunger for love and acceptance, and careening from relationship to relationship and impulse to impulse in a desperate attempt to control those feelings."  

One possible diagnosis that Marilyn may have suffered from is Borderline Personality Disorder. 
Just based on what most of us have come to know about this beautiful, talented, emotional woman, it's easy to see her fitting into having at least 5 of the 9 symptoms required for a BPD diagnosis:
  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation (also known as "splitting")

    Marilyn married at a young age to her 21 year old neighbor and divorced shortly after his return from the military.  She also married baseball legend Joe DiMaggio and divorced 9 months later, and playwright Arthur Miller, who she divorced 5 years later. In addition, it is speculated that she had numerous intense and fleeting affairs, including with President John F. Kennedy and with the president's brother, Robert.
  • Identity disturbance: Markedly or persistently unstable self-image or sense of self

    Marilyn grew up as Norma Jean, never knowing her father and knowing that her mother was committed to a mental institution due to severe psychological issues. She bounced from foster home to foster home and then from marriage to marriage, in the meantime creating a new identity for herself as Marilyn Monroe, changing her hair color, name, and personality.  While many stars take on a new name for show business, Marilyn took on a whole knew persona -- one that she thought would likely get her the love, attention, and adoration she so desperately sought since she was a young child.
  • Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)

    Sex and substance abuse.
  • Recurrent suicidal behavior, gestures, or threats, or self-harming behavior

    It is unknown if Marilyn Monroe self-harmed (other than through substance abuse), but self-harm/suicidal behavior ultimately took her life.
  • Emotional instability in reaction to day-to-day events (e.g., intense episodic sadness, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

    This may have been the case, especially in the days leading up to her being fired from her last movie.
  • Chronic feelings of emptiness

    Well documented as having experienced this. Portions of her diary were recovered, and this was a repeated theme.
  • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
  • Transient, stress-related paranoid ideation or severe dissociative symptoms"
    Symptoms sourced from (National Institute of Mental Health)italicized text speculated by

Eventually, with all of her intense feelings and no real support to guide her and help keep her safe, at age 36, Marilyn Monroe ended up taking her own life.  One wonders what might have been different if she lived today and had the support and resources available to us now. 

Unfortunately, at the time when Marilyn graced this planet, much of what we now know about mental illness had not yet been discovered, and although it is true that we still deal with stigmas around mental health, the risk Marilyn would have had to take to "out" herself as suffering from mental illness and to seek what help was available at that time was great. In contrast, today's celebrities such as Demi Lovato, Winona Ryder, and Catherine Zeta Jones (and many more) have all "come out" as having mental illness.
We are very fortunate now that when we see women (and men) who exhibit many of the behaviors that Marilyn exhibited, we can help to support and guide those who are enduring similar suffering today. There is hope.
Dialectical Behavior Therapy, which did not exist in Marilyn's time is the treatment of choice for Borderline Personality Disorder. I have personally found it very effective in allowing me to discover who I am and to create a life worth living.  It has helped me to control the majority of the impulsive behavior and tumultuous relationships I have repeatedly found myself in. 
Perhaps most importantly, as I, like Marilyn, was given up to foster care, come from a family with an intense mental illness history, and married young only to divorce, I have begun to believe that I am worth something, despite not having that modeled to me for much of my childhood. I am learning the skills that I would have learned had I been brought up in a validating environment.

If you suffer from Borderline Personality Disorder and/or identify with Marilyn Monroe's story, take hope. There is help today that wasn't available then. You need not be a candle in the wind, and you can get well and enjoy life again.

Recommended reading "Lost in The Mirror: An Inside Look at Borderline Personality Disorder:"


The author of this blog post has since RECOVERED from Borderline Personality Disorder and no longer meets the criteria for a BPD diagnosis. There is HOPE for you!  Recovery happened through a commitment to DBT. Debbie now teaches the DBT skills that helped change her life over at  where you can take online Dialectical Behavior Therapy Classes from anywhere in the world. We only wish this therapy existed when Marilyn Monroe graced this planet, but today YOU *can* overcome this disorder.
Thank you for reading.
More soon.


If you suffer from BPD, there is HOPE!

Yesterday was pretty intense, and I’ve been thinking about how to share the situation with you in a way that would be encouraging to you. If you’re suffering from Borderline Personality Disorder and can’t even imagine getting well, let alone being able to return to the site of a trigger to help someone else while not getting triggered yourself, read on. May this encourage you that there truly is hope!

A friend of mine has been suffering mentally. She doesn’t have BPD (Borderline Personality Disorder) like I do,  but OCD (Obsessive Compulsive Disorder), Generalized Anxiety, and Depression.  I have shared all of these diagnoses at one time or another.  Her eating and sleep have been disrupted, and she’s been carrying on for months in a panic state, nearly all day every day.

Finally, yesterday, she made some comments to her therapist (I won’t repeat them here, but they were specific self-harm threats), and, as is the law in the United States, he was obligated to put  her on what is called a “72 hour psychiatric hold.”  This means that she would need to go to the emergency room to be medically cleared, and once a bed became available, she would be transferred to a psychiatric hospital to keep her safe. She would also be evaluated.

When I got the call yesterday that she was in the emergency room, interestingly, I did not panic.  For those who have been following my blogs for a while, you know that showing up at the emergency room for a psychiatric crisis was a routine thing for me – at least a couple of times a year. This past June was my one year anniversary of not doing that.

At my one year anniversary, even though I was proud and excited that through DBT (Dialectical Behavior Therapy) I have found new skills and ways to cope, I was nervous that if I celebrated, I would soon find myself back there, embarrassed that I had shared my accomplishment.  Through some work with my hypnotherapist, I was able to get rid of the scary images and thoughts that I had associated with the emergency room and was able to begin seeing it as a place that provides services for people who really need it.

Yesterday was a testimony to the success of my hypnosis session, as I was able to visit my friend in this room – the very same room I had often been put in for psychiatric observation, yet I was not triggered. I was able to be fully present with my friend, not making it at all about me, but all about her. I actually recognized the nurse who was overseeing her. I think she recognized me, too, but of course, we didn’t utter a word about it.


I stayed with my friend for a couple of hours.  I listened with compassion, love, and non-judgment.  She was very tearful and panicky when I arrived, but I noticed her becoming more grounded and calm as we talked and even laughed a bit.  I held her hand. I hugged her. I told her I loved her.

When she freaked out and told me she worried that she was burdening me and that I must really want to leave, I told her that I had been through this before, I understand her suffering, and that my ability to be compassionate toward her was limitless. There was nothing she could do to push me away. I would not leave or abandon her.

I encouraged her to take the Ativan that the doctor was offering, and as it kicked in, I suggested she lay back on the hospital cot while I guided her in meditation. She was happy to do so. When the nurse noticed what we were doing, she walked in slowly, smiled, and turned off the lights for us. 

My friend eventually drifted off into a light slumber, but not before saying, “It’s okay, Debbie. I’m going to rest now. You can go home, and I’ll call you in the morning.” 

I went out to the security guard who was watching over her (another requirement in the U.S. when you are on a psychiatric hold), and I explained that she seemed to be doing better, that we had meditated, and that she was off to sleep. I let him know that my phone number was in her purse, should she need me.

I left the hospital, and as I did, I looked around at the sites and sounds that had once been so scary for me. I thought about the transformation that has taken place within that allowed me to be back in that place, this time on the other side of the fence, supporting, encouraging, and loving someone else through the very same kind of suffering I had experienced so many times.  I really would not have believed it was possible if you told me a year ago that this would be the case.

If you have Borderline Personality Disorder or any other mental illness, keep hope! If you work hard, don’t give up, and practice the skills that you learn through therapy (in my case, DBT skills), your entire life can be transformed. Meaning can be given to your suffering as you are able to eventually feel safe and free enough to not only enjoy your life but also to help others.

Thanks for reading.
More soon.


Oops! I did it again... Impulsiveness and Regret in BPD

Today I lacked some judgment. Because things have been going well at work, and I received accolades from my boss publicly in two meetings this past week, I had this brilliant idea that it might be a good time to ask for a raise. It wasn't.

If only I had done due diligence rather than respond to a very intense urge to act impulsively by asking today instead of thinking it through, I would not have been left with the feelings of regret and embarrassment.  I wouldn't have a troubling scenario to now torture myself with over and over again.

Up until today, I had been doing really well with impulse control. For example, for a while there, I would emotionally respond to emails right away, often regretting what I had written just moments later -- but it would be too late. I would cause myself so much unnecessary distress and anxiety because I didn't think things through until after the fact.

I've been practicing mindfulness around emails, including putting a space (time) between my initial reaction and actually responding to the other person. My goal has been to move away from always needing to be seen as right and competent to simply being effective. For me, being effective means I get my point across in a professional manner that I don't end up regretting.

It was difficult at first, as it is with any impulsive behavior. I knew it would take practice, and with time, I have come to the point where I no longer respond immediately and emotionally to emails.  In fact, this practice has extended to other areas of my life when I feel an impulsive urge to do something potentially self-sabotaging or damaging.

That's why I'm not entirely sure why today I decided to ask my boss for a raise. What was I thinking?  I didn't take the time to look at the financial health of the company, and in reality, everyone is working pretty hard to maintain their jobs in this economy. I certainly did not deserve one any more than the next guy.

When I didn't get a "yes" answer, I immediately felt embarrassed, ashamed, and regretful.  My boss reassured me that I did nothing wrong, joked with me, and simply explained that it wasn't a good time for the company and that no one would be getting a raise at this time.

I have no reasonable explanation as to why I asked at this point other than that the desire to ask swelled up in me like an insatiable urge.  I needed an answer. Even though I knew in my gut that I probably shouldn't have asked and anticipated that I would probably regret it (two red flags that have successfully helped me guide myself to my DBT skills on many a recent occasion), I still followed through on the urge.

I have been feeling emotionally vulnerable for the past couple of days - very heightened and emotionally sensitive, as many people with Borderline Personality Disorder can understand.

Perhaps practicing some distress tolerance and mindfulness skills would have helped to intercept my actions, but I cannot continue to beat myself up over it and be consumed with regret. At some point, when we do something counterproductive and we regret it, we must radically accept that it is what it is and hopefully learn our lessons for the next time we are faced with a similar situation.  This is what I have chosen to do.

Do you have a habit of acting impulsively, even when you get a hunch that you might later regret your actions? What coping skills have helped you to avoid such behavior?

Thank you for reading.
More Soon.

Being Emotionally Sensitive in an Abrasive World (Borderline Personality Disorder)

Ok. So perhaps the world is not quite "abrasive." At least not entirely. But to someone with Borderline Personality Disorder, it can certainly feel that way.  

Dr. Marsha Linehan, founder of Dialectical Behavior Therapy (DBT) for the treatment of BPD, likens those of us diagnosed with the disorder as third degree emotional burn victims. Ouch.

This came to mind today at work.

The day started out pretty ordinary, though I was in pain due to TMJ, which no doubt affected my vulnerability level. I had a headache and felt nauseous, but as I usually do in times like these, I put on my makeup, got dressed, and went to work.

It wasn't easy. One of my coworkers had been on vacation for a week, and the moment I walked through the door, she was ready to talk about her exciting adventures. Any other day, I'd be excited, but I didn't feel well, and when I don't feel well physically, my sensitivity around emotions is stronger, too.

I felt so anxious. I smiled through it, as sincerely as I could. I listened to her fun stories, and then I focused on my work.  

But every interaction that came my way seemed to heighten my anxiety.  My appetite was low (which is a trigger for me), and when a coworker said, "You need to eat more than that [breakfast bar and peanuts] for lunch," I could literally feel the surge of cold adrenaline rush through my veins as my mind went into overload and into anxiety (fight or flight) mode. 

I wasn't in any real danger, of course. We all have off days physically and emotionally. We all have days where are appetite is less than usual so we graze rather than eat the way we normally do, but I was really triggered by the comment and needed to use my skills in order to keep my composure and carry on at work.

The average, non BPD person may not understand how incredibly intense we can experience our emotions and how vulnerabilities, such as not feeling well or not sleeping well the night before can really have an effect on how we experience our days, mood swings, and our ability to cope with things that we can ordinarily handle.

I used:
  • Self-soothing by using Wise Mind and telling myself that today is just "one of those days," and that this, too, shall pass
  • Distraction by diving into my work and focusing
  • PLEASE skills by picking up a bagel, even though I didn't feel like it. I ate it slowly, and it actually helped
  • Was mindful by focusing on my breath and just noticing the various sensations and thoughts that were coming up

All in all, I am beginning to feel better. Self-care continues tonight with a nice hot shower, some good tv, and snuggles on the couch with the cats.

It takes some adjusting to radically accept that the day-to-day challenge of navigating the world when you have BPD isn't always easy, but as we apply the skills and get through the challenges, it is certainly worth it.

Thanks for reading.
More soon.


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