borderline personality disorder Tag

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Therapist Recommendations For Loving Someone with Borderline Personality Disorder

by Counseling and Wellness Center of PittsburghMay 12, 2022 borderline personality disorder, BPD, BPD Relationships0 comments

There has been a lot of recent media attention surrounding Borderline Personality Disorder—Pete Davidson has been open about his diagnosis and more recently Amber Heard was evaluated to have Borderline Personality Disorder by a forensic psychologist who was hired by Johnny Depp’s legal team. I am hoping that I can show you the positive side of Borderline Personality Disorder and offer recommendations on loving someone with Borderline Personality Disorder and making your BPD relationships brighter and healthier.

Borderline Personality Disorder (BPD) can have features that include fear of abandonment, patterns of unstable relationships, rapid changes in self-image, and risky behavior.

With the pervasive nature of these mental health symptoms, treatment is essential, which includes a solid support network.  

If you are a friend, family member, or partner of someone with BPD, you are probably well aware of the relationship challenges. Also, keep in mind those with BPD can (often unbeknownst to themselves) create the issues that cause abandonment, which they may fear the most. 

Aside from these challenges, having a loved one with BPD can be enriching and rewarding. I can easily cite the positive aspects. I’ve frequently been motivated by the inspiring love for their passions.  Their enthusiasm for life can be very contagious. They can offer dark humor and quick wit when you need to be cheered up from your own negative emotions. 

In my experiences with clients and loved ones with BPD, I wanted to share some insight. I’ve learned that patience and empathy are the foundation for mutual growth.  

I hope to offer some recommendations that can make BPD relationships brighter and healthier:

  1. First and most importantly, realize there are limits and boundaries to every relationship.  Give and take isn’t always 50/50, but the relationship does not stay healthy if one’s time and energy is on a pattern of depletion. 
  2. Clear communication of wants and needs are essential. Make sure you have your desires established early into the relationship, while also respecting those of your partner.
  3. Individual treatment. For your loved one, appropriate therapy is ideal. This clinician should be experienced in personality disorders. Even more importantly, this clinician should focus on Dialectical Behavioral Therapy (DBT). DBT is a therapy specifically devised for Borderline individuals that focuses on healthier coping and inward reflection. To manage your emotions properly, consider therapy for yourself.
  4. Research and learning.   Receiving this diagnosis can be overwhelming for the patient as well as their support network.  Finding out a loved one has a BPD diagnosis can bring up an array of questions. Make sure you educate yourself using reputable resources. 
  5. Self-care. Both you and your loved one need care and balance; it is highly important to carve time for yourself. Your health is just as crucial as those around you.
  6. Support in any relationship is crucial, but even more so to those living with BPD.  Look into joining a “Friends and Family” DBT support group online. 
  7. Be Aware of Love Languages.  Part of BPD in relationships is fear of abandonment, and small gestures can go a long way. Find your love languages and keep these in mind when you want to express appreciation.
    1. Words of Affirmation: Telling the person they are loved or giving sincere compliments even via text.
    2. Gifts: Thoughtful doesn’t have to mean expensive; think about their special interests or even delivering them a treat.  
    3. Quality Time: One-on-one, no phones/no distractions. Be present with each other.
    4. Acts of Service: Schedule time to work on tasks they find overwhelming, even if you find it mundane.
    5. Physical Touch: Even close proximity can express to your BPD loved one that you are near and dear.

The emotional connections we have in life take thoughtful cultivation. There is work required in every relationship, but elevated patience and effort are needed when it comes to those with personality disorders. I encourage you to have open conversations with loved ones with any and all mental health needs so that you can discover more joy. 

Written by Rachel Taylor, a licensed professional counselor (LPC) and Nationally Board Certified Counselor (NBCC) with Counseling and Wellness Center of Pittsburgh.

Pruthi, S. Borderline Personality Disorder. (2022, May) The Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237

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Healthy Alternatives to Self-Harm

by Counseling and Wellness Center of PittsburghFebruary 28, 2022 borderline personality disorder, self harm0 comments

Trigger Warning: Self-Harm

Coping skills are a way to deal with difficult situations, people and emotions. Many people enjoy listening to music, writing, exercising, and painting on days they do not feel the greatest. However, for some people the emotions can feel so overwhelming they turn to self-harm looking to release the emotional pain. 

March 1 is Self-Injury Awareness Day— a day that focuses on increasing education and support on a misunderstood problem. According to research from the National Library of Medicine, about 17% of all people will self-harm during their lifetime.

What is Self-Harm or Self-Injury?

Self-harm is any form of hurting oneself on purpose. The pain from self-harming is often a distraction from the mental pain one may experience. Usually, when people self-harm, they do not have the intention to attempt or commit suicide. Although anyone can self-harm, it is more common among people with mental health disorders such as Depression, Anxiety, Borderline Personality Disorder, Eating Disorders and Post Traumatic Stress Disorder.

Self-harm looks differently for each person. Below is a list of some of the most common types of self-harm:

  • Cutting
  • Burning
  • Pulling out hair
  • Carving words or symbols into the skin
  • Scratching
  • Picking at existing wounds
  • Piercing the skin with sharp objects

How To Deal with Self-Harm

Painful experiences and emotions can be really hard and overwhelming sometimes. Having the desire to find ways to cope and process the difficult things in your life is totally normal. If you are using self-harm to manage your emotions, we want you to know that you are not alone.  Here are some resources and alternative ways to cope with your emotions. 

  1. For emergency care. You can call the Resolve Crisis Hotline at 888-796-8226. Resolve is a 24-hour, 365-day crisis service that is free to all Allegheny County Residents. They provide a 24-hour hotline you can call to speak to a trained clinician. A mobile crisis team that can travel anywhere within Allegheny County to respond to a crisis; they will provide in-person support and will work to arrange further care and stabilization, if needed. Resolve also has a walk-in center, no appointment is needed. The walk-in center is located at 333 North Braddock Ave. Pittsburgh, PA 15208. You can also call the National Suicide Prevention Lifeline at 800-273-8255 or Text HOME to 741741 to reach the Crisis Text Line. 
  2. Get Outside. Changing your environment can offer a distraction and give you time away from the self-harm tool. Being in nature also has a calming effect; walking around your neighborhood or on the trails can help increase your mood. Visiting a nearby park and/or stopping by your favorite place can help you feel calmer and at peace.
  3. Physical Activity can also be used as a distraction to help increase your mood and relieve some of the overwhelming emotions. Using sports or exercise can help resist the urge. If you do not feel like moving your body too much or feel like you have low energy, try yoga, Zumba, or do some basic stretches. Many videos can be found on YouTube.
  4. Listen to Music. Make a happy playlist and use the playlist during times you are not feeling well mentally.
  5. Mindfulness Activities. Using meditation, progressive muscle relaxation, and guided imagery can help us calm down when we are feeling overwhelmed. You can also take some deep breaths while using an adult coloring book or a color on a blank piece of paper.
  6. Talk to a Professional. The intention may not be to commit suicide however, self-harm can be dangerous both emotionally and physically. Talking to a therapist can help you process difficult emotions and learn new ways to cope. 

The Counseling and Wellness Center of Pittsburgh is here to help you find a healthy alternative to self-harm. Please contact us at 412-322-2129 if you need support.

Written by: Kionna Howell, LPC at the Counseling and Wellness Center of Pittsburgh.

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People with Personality Disorders Do This In Relationships

by Counseling and Wellness Center of PittsburghSeptember 8, 2020 borderline personality disorder, Bowen Systems theory, healthy relationships, narcissistic personality disorder, Personality disorders, Unhealthy relationships0 comments

People with Personality Disorders Do This In Relationships

Differentiation of Self: Learning to balance Self Needs with the Needs of Others

 

We can all agree that balance is a key component to healthy living. Sometimes it comes naturally, but more often than not, balance is really hard to maintain.  One of the most difficult places to find balance is in our relationships.  If we want to find balance, it is worth taking some time to think about the things we are trying to balance between. Being in relationships is like walking a tightrope.  There are some people who have a pattern of relating where they have not developed coping strategies that help them work through strong emotions. These people, often personality disordered as defined by their rigidness and complex unhealthy ways of understanding themselves and others, cut off anyone who challenges or counters them. We are constantly balancing between our own individuality on one side, and our desire for a sense of togetherness on the other.  Whereas emotionally healthy people welcome differences in others, personality disordered people have not moved beyond the immature way of viewing the world that understands not everyone is the same. Entering into relationships fulfills the human desire for a sense of belonging or togetherness.  Once we are in a group or relationship, learning how to navigate around individual differences often proves to be quite difficult. It is easy to succumb to charged situations and react based on emotions rather than a thoughtful choice. ‘Differentiation of Self’ is the ability to interact with others while, at the same time, regulating your own emotions. Think of how narrow your world would become if your default was to run away from every person who you cared about who said or did something you didn’t like. This is however the reality that individuals with borderline personality disorder and sometimes narcissistic personality disorder create. 

 

Think about a disagreement that is currently causing you frustration in one of your close relationships.  You probably share commonalities with the person you disagree with, but at the same time your individual differences create tension.  What do you do?  If you are afraid of creating distance in the relationship you might just blindly agree with the person.  You wouldn’t lose your closeness, but you would sacrifice some of your individuality.  On the other hand, you could cut the person off emotionally, and distance yourself in the relationship. This would allow you to maintain your independence, but you would lose your closeness and possibly the relationship. Both of these responses are irrational and extreme, a product of all or nothing thinking that are often related to several personality disorders. Neither of these options are really healthy.  Each is an escape in reaction to the emotional pressure of disagreement.  

 

Differentiation of self is an idea that describes the ability to regulate your own emotional climate rather than getting drawn in or overwhelmed by the emotions of others.  It also has to do with a person’s ability to interact with others without losing their sense of self. This is because a well differentiated person is able to hold the tension between their needs and the needs of others without becoming overwhelmed and acting purely on the strongest emotional push.  Someone who is “well differentiated” is able to realize the difference between their own emotions, and the emotions of the people around them. Their choices are thoughtful, taking their emotions into account without being ruled by them.  They are able to find peace even in difficult situations and respond thoughtfully in moments of pressure.

 

 Think of individuality and togetherness like two sides of a coin that are distinct, but at the same time inseparable.  One side has to do with our concept of self. It is the aspects of our personal life and experience that make us unique and different from others.  On the other side, we have a desire to share similarities with others, and to be a part of a group. This is the desire for togetherness, or a sense of belonging.  When we are differentiated, we have the ability to enter into a relationship and not lose ourselves. We are able to identify our own emotions and thoughts when responding to tension in a relationship, and we do not react to the emotions of others, but rather intentionally respond. We do not give up ourselves to be with someone, but rather we learn how to truly be ourselves with someone. Learning to regulate our emotions in charged situations is the skill that allows us to hold the balance between our needs and the needs of others.  It is a necessary to be able to experience tension in order to have difficult conversations.  Healthy relationships rely on our ability to express ourselves in a way that is authentic to ourselves, and at the same time sensitive to others.  Being well differentiated protects you from getting uncontrollably pulled in by your own emotions or the emotions of other people.  Ultimately, it allows you to enter into relationships fully, in a healthy way, without having to sacrifice your sense of self or losing your own identity.

 

Differentiation of self develops in our family of origin as we learn how to view ourselves as individuals, but also learn to maintain intimate relationships. It was first described by Murray Bowen, one of the pioneers of family therapy and the founder of Family Systems Theory.  He discovered that in a healthy family, members develop the ability to have a sense that “I am my own person, but I am also a part of my family.”  Ideally, the family is the place that we learn this skill of balance and integration.  In learning about the similarities that unite me to my family members, I am able to have a sense of belonging.  In learning about my own uniqueness, interests, and beliefs, I learn that I am also my own person.  The challenge of the family is to teach this balance to children and cultivate a balance between our head and our heart. When we don’t learn this balance, we learn instead to be emotionally reactive.

 

Emotional reactivity is the key distinguishing aspect between people who are well differentiated or poorly differentiated. Differentiation of self is an ideal that we aim for and being aware of how we react to others is the first step in becoming more differentiate. Learning to manage our thoughts and our feelings has a direct result on how we are able to authentically enter into and navigate relationship.  If we are not able to differentiate our thoughts from our feelings, then we become vulnerable to being overcome by the pressure of other people, or our own impulses in the present moment. 

 

What can we do about it?  None of us are as differentiated as we could be.  In fact, even Murray Bowen said that he would not consider himself perfectly differentiated!  We can all chose to be dedicated to growing in differentiation.  It will benefit us, our friends, our families and especially our close relationships.  It is easy to get caught up in the past, or the future, but the only thing we can change is right now.  Differentiation begins with thoughtfulness and consideration of the present moment.  Why don’t you try to do a quick check in with your emotions?  Take a few deep breaths.  Just notice, what is it you’re feeling right now?  Has there been any strong emotions welling up as you read this post?  Just try to notice those feelings, the more aware we are of our feelings, the less likely they are to overwhelm us.  By simply paying attention to the present moment we give ourselves the chance to be more differentiated.  Next time you are in a frustrating situation with someone try to do the same thing, just notice your feelings.  Pay attention to what your emotions are telling you and listen to them while taking a few deep breaths.  Rather than reacting to the situation, try to respond thoughtfully after checking in with your emotions.  If your knee jerk response is to ‘cut and run’ every time you experience an emotional reaction in a relationship, notice this too and try to adopt healthy self soothing techniques instead of running away from inevitable heightened emotions that come from having close relationships. The key to change is always and only in the present moment.  By paying attention to the present moment we allow ourselves to truly enter into what is going on around us, without being swept off our feet.  Relationships are difficult and require a lot of work.  By paying attention to our emotions, we can learn to enter into relationships in a deeper, more meaningful way.  Differentiation of self is what allows us to truly be ourselves in an authentic way, and at the same time meaningfully enter into relationships with others.

By: John Paul Dombrowski- Counseling and Wellness Center of Pittsburgh in Canonsburg.

 

Counseling and Wellness Center of Pittsburgh

Counseling and Wellness Center of Pittsburgh

Citations:

 Foose, K. (2018, February 07). Differentiation of self through the lens of mindfulness. Retrieved September 07, 2020, from https://ct.counseling.org/2018/02/differentiation-of-self-through-the-lens-of-mindfulness/

Baney, D., 5, J., 3, O., 28, E., & *, N. (2015, September 14). Differentiation of Self. Retrieved September 07, 2020, from https://drbaney.com/category/differentiation-of-self/

Eight Concepts. (2017, November 22). Retrieved September 07, 2020, from https://thebowencenter.org/theory/eight-concepts/

Kerr, M. E., & Bowen, M. (1988). Family evaluation: An approach based on Bowen theory. New York: W.W. Norton.

Nichols, M. P., & Davis, S. D. (2019). Family therapy: Concepts and methods. Hoboken: Pearson.

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We Raise Them To Be Good Girls

by Stephanie McCrackenJanuary 8, 2015 counseling, feminist, mindfulness, personal growth, psychotherapy, wisdom0 comments
Little Girls in Dresses Like To Play In The Mud

Little Girls in Dresses Like To Play In The Mud

We raise them to be good girls, to nod politely during fine conversation strung on during respectable hours with respectable people. We raise them to be pillars of hope, encouraging others in their struggles, we hug them and cradle them from the womb to teach them that they too should hug others, pearls of sweat always wiped away before becoming visible, to be the tirelessly devoted caretaker. We raise them with their kitchen play sets and plastic burgers and fries to prepare, toil, to serve those near and dear, insistently offering heaps and dollops of crème fraichely flavored affectionate nurturance. We raise them to banter upon the midnight keys of the baby grand, to cajole the audience with a fine melody, high five you little entertainer, pat, pat upon your severely strewn locks all wrapped up in an impeccable bow, “you are such a good girl.”. Oh, indeed, she hears you, her tiny countenance aglow with your praises, forming a map, a how-to manual which will beckon the praises of all of the others, a lifetime of others. A heavily laden back drop of nodding, and “yes sir” and “yes ma’am”, discipline and structure abounds her omnipresent formative years, she will please and she will shine.

Climbing trees and being a girl...

Climbing trees and being a girl…

This little essay is for all of those good little girls, turned to women that must learn how to say “no sir” “no ma’am” here is the boundary that draws the distinction between you and between me. Sometimes she must say “no” and nod “no” for nobody else other than her, and her own self-interest, and sometimes she must walk away still being a “good girl” because as she is learning her obligation is to nurture herself, too. Here is to the good girls who have traded in their bright-eyed baby dolls and longed instead to sit in solitude, sometimes for hours on end, to strewn together words upon words which offer semblance to their own pale logic. This is for the good little girls who leave those plastic frying pans, those dull golden rubber buns left to acquire a lifetime of mold. This is for the little girls that are too busy collecting grasshoppers and salamanders, head to toe crusted in mud, smelling not like perfume and soap but like straw and finely decomposing fall leaves, yes little girl “we love you too”. This is for the little girl come lady who screeches out an alarming melody, a protestation, a vigorous “No! I don’t want to wear your dresses, I won’t be a good little girl, I want to listen to crickets and cicadas and feed the goats in my denim jean coveralls, someday I want to be the CEO and walk about with ease in a simple pair of flat shoes meant for utility!” For the little girl that doesn’t want to smile and nod, on some days she wants to stomp and to curse a big “fuck you world!” She wants to say it and not fall from her imagined place of grace, clinging to all of this sturdy awareness, panicking that she has careened over the invisible line, teetering on becoming a very bad girl indeed. Yes, good and bad and all of these startling dichotomies, black and white pervade in a world of pastels, blues and greys, there must be something beyond the stark definition, the deft appraisal, and no girl wants to be tossed to the bad girl side when it comes to such grossly serious matters. Even with messy hair, smeared mascara, no mascara, when we have stayed up too late, when we can’t wake up in the morning, when we have allowed cruel words and actions to rush passed angrily contorted lips, we still want your love. When we have shattered our picture perfect with heaps and doses of vapid reality, we still want your love, we still want to be a good-girl turned woman, a woman worth loving, to you, and we want to fill up our own hole that reeks of neediness, the irrational desire for your love which we know needs to be sustained by our own self-love, a love that remains beyond these tendencies of fluctuating moods, beyond good-girl and bad-girls, the place of total acceptance, the point of compassion for our own humanness, yes, right there, that space of self-nurturance, maybe we are good-girls turned woman after all.

In care and warmth,

Stephanie McCracken MSPC

Psychotherapist ; Reviving Minds Therapy

1010 Western Avenue Pittsburgh Pa 15233 Suite 100

412-322-2129

 

 

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On the Border and Crossing The Line, Recovering from a Close Encounter of Another Kind

by Stephanie McCrackenJune 9, 2014 counseling, couples counseling, couples therapy, psychology, Uncategorized0 comments

Red_umbrella_love_couples_wallpaper1

For any of you who have felt yourself a part of a relationship which was dizzying in its highs and staggering in its lows, no matter how brief or long, your head very well may be feeling woozy in recalling the rapidity of its pace. While there are indeed many personality types and pathologies which can lead themselves to destructive cycles in the interpersonal domain, we will today briefly explore Borderline Personality Disorder and what this kind of encounter may mean for someone who is attempting to heal and recover in its wake. Much literature has focused on the trait of borderline personality disorder as it relates to women yet in recent years clinicians have noted that there may be a growing number of males who meet the diagnostic criteria for the disorder.

While there are many typologies of the borderline character structure there will undoubtedly be an intensity to the initial meeting phase. For a woman meeting a borderline male it’s likely that she will be dazzled and showered with heaps of attention and affection, “at last a male who seems to thrive upon open emotional discourse”. Despite all of those enchanting words and the promise of the sort of intimate encounter that one has been eagerly waiting for, the Borderline male or female will inevitably change as soon as he or she detects that you have been won over. What was once Casanova like attention and praise will become brooding and coldness, likely even implacable possessiveness. The conundrums lies within the fact that the more closely one moves to the center of a borderline person’s inner constitution the more resistance that one will note. The borderline has a hallmark knack for stirring up fights and dramatic interplays which make them feel more alive, the function of the heated angst is to shield against the emptiness of their true center. A borderline likely has suffered some trauma or abuse in early childhood and the sustainment of true emotional intimacy is a most insurmountable task for this person. If this cursory note sounds like someone you or a loved one now or eventually it will be important to seek professional help and be careful. If you are in the process of leaving someone with Borderline Personality Disorder (or any other domestic abuser) this is the most dangerous time. The Borderline Personality will not respect or note boundaries or have any qualms about stalking or seeking to ruin a victim’s life. Their key note is abandonment and the game stakes have just begun increased for the borderline when a friend, lover, or casual acquaintance is attempting to diverge on life’s path. This often recreates a point of abandonment, abuse or neglect that the borderline had experienced in early childhood. The borderlines inability to come to terms with healthy boundaries and no means no mentality makes them a typical recipient of restraining orders and PFA’s. Breaking-Up-Couple

Yet many people who are in a relationship with a person suffering from Borderline Personality disorder may not recognize the issue until months or even years into it, this is true even for intelligent and successful people who maintain such vivid memory of the courtship or fall victim to the Borderlines intense need to recouple after falling apart. If you were or are in relationship with a person who exhibits Borderline personality traits or a full blown disorder there is a chance that you too have had some trauma in your childhood or adulthood which puts you at risk to accept this kind of attachment. It can be significantly challenging to see the signs of the disorder as the Borderline is very skilled at using something clinicians call “Gaslighting,” for instance when this person goes into one of their episodic fight picking modes they will literally leave their victim with the feeling that it was their fault, they may cause a friend or partner physical, emotional, spiritual harm yet they will always leave their victim believing that they are to blame or even deny that anything even happened. The Borderline also may exhibit martyr like tendencies, spewing to all who will listen of how much they love their victim and how much they have suffered for their love, they can even make bystanders believe that the victim is the crazy one during their epic and frequent altercations. If you recognize yourself in either part of this description you may want to seek the help and advice of a psychotherapist or other mental health professional.

While diagnosing Borderline Personality Disorder is the domain of a psychological professional who has been trained to administer measures and tests, here is the DSM IV-TR criteria for achieving the diagnosis.

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning in early adulthood and present in a variety of contexts as indicated by 5 or more of the following.

1) Frantic efforts to avoid real or imagined abandonment.

2) A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

3) Identity disturbance: markedly and persistently unstable self-image or sense of self.

4) Impulsivity in at least two areas that could potentially be self-damaging. (Spending, sex, substance abuse, reckless driving, binge eating.)

5) Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

6) Affective instability due to a marked reactivity of mood (e.g. intense episodic dysphoria, irritability, or anxiety usually only lasting a few hours and rarely more than a few days.)

7) Chronic feelings of emptiness.

8) Inappropriate and intense anger or difficulty controlling anger (frequent displays of temper, constant anger, recurrent physical fights)

9) Transient stress related paranoid ideation or sever disassociate symptoms.

Keep in mind all of you singletons or those recovering from a whopping dating fiasco, that if something doesn’t feel right then it probably isn’t, if someone is moving too fast for your comfort then there may be something underlying all of that intensity and there is never any case in life which should permit a healthy person from recognizing that within life, love, and conversation, no means no just as well as yes means yes. J

In good health and love,

Stephanie McCracken MSPC

Offering Psychotherapy and Marriage Counseling

412-215-1986

Reviving Minds Therapy

1010 Western Avenue Pittsburgh Pa 15233

 

 

 

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