BPD Awareness Month (Unstable Emotions)(DBT-Dialectical Behavior Therapy)

 

Todays Topic is ‘Unstable Emotions’(With a Bonus section on DBT) Now this is the Penultimate Topic & I’d suggest it is the Queen of the Main Problems relating to Borderline Personality Disorder. Tomorrows Topic will be in my opinion the King. Now there is a lot of research into this subject there is a lot of data to back up the theory that unstable Emotions comes from our childhood & upbringing & how our parents or care givers raise us from baby ages throughout our life.

There is also the side of the debate that life style choices affect our emotions, Also another side of the debate is Things out of our control that affect our life’s such has a Death or a Loss or a Family Breakdown etc, if they happen at a early age it suggests it shapes us for the rest of our life’s, example if a 7 year old’s family unit beaks down, then they have several things going on, 1stly that child will be suffering because of the family break, 2ndly he/she will be traumatised by the before/after circumstances, maybe a mother/father have left the home alongside a sibling or a family pet or even the Home, 3rdly they will also be dealing with emotional trauma of the aftermath, which are different to the emotions of the ‘At the time’ sort of thing, its like when something happens to you, your in shock for a while and then all of a sudden the shock has gone and bang a rapid emotional state comes where your all over the shop. 2 very different states of emotions, relating to the 1 event. So that’s the example of a 7 year old. Now lets go a bit further to a 18 year old with the very same circumstances with no changes at all.

The emotional mess this young adult would be going through is somewhat the same, but with this example the 18 year old male or female will have a lot of Anger & unlike the small child, the 18 year old will be able to vent this anger out, good/bad/in different, that’s irrelevant, what matters is they will be able to vent it out, unlike the 7 year old where most people will be saying this, what I term has ‘Anti-Human’ Line they will say ‘Oh don’t worry THEY will GET OVER IT’ Now that is perhaps one of the most destructive things you can ever say to anyone, let alone a child. The unstable emotions that, that 18 year old will be going through is destructive because all of a sudden then are thrown into a world of.. Something they could not of pictured in their worst nightmare, And trying to deal with that is somewhat impossible.

The point is no matter the age in my opinion the destruction will have the same or very similar patterns, unlike what I said at the very beginning of this, that was NOT my opinion, I disagree with that thought that if your smaller it affects you throughout your life, I say if it affects you that badly no matter the age it will affect your life full stop. I often share a lot of Clinical information & a lot of the time I personally disagree with it, but that’s my personal perspective, I share the clinical info because its based off 100’s of thousands, dare I say Millions of data collected. So 1,000 people reacting lets say A, and I react B, and I’m the 1 in the 1,000. That’s why I choose to give you guys all the clinical info in all my blogs so that you guys can get the best idea of the subject in hand, with my own personal perspective which is one thing, and I give you guys the data based info has a 2nd thing.

So you guys can get a good grasp of the subject, from someone who lives it and from the people who have worked in that field. So you get the best of both worlds really. I do agree with a lot of the info I share, but there is somethings I do disagree with, but that’s all apart of life isn’t it my friends. I just wanted to share this. Also them examples I gave the above is from a slight personal perspective, not entirely my perspective, but it did some relation to my personal life, but not in its entirety. Now I’m going to give you some Clinical Info now Guys, Now there is going to be a Bonus section of DBT, I wont be speaking on that part from my personal perspective, But what I will say is iv had it and it worked very very well.

Imagine you have a cut. The skin around your cut heals. But it heals all wrong. The scarred tissue is extra sensitive. So much so that every time you simply touch the area, its like the wound tears open again, and again, and again; and the pain peaks every single time. Now imagine this wound represents your emotional sensitivity and how you deal with the world every day. This is akin to the emotional susceptibility of borderline personality disorder (BPD).

As Shari Y. Manning, Ph.D, writes in her excellent book Loving Someone with Borderline Personality Disorder, People with BPD have an exquisite vulnerability to emotions. And this susceptibility is hardwired.

For instance, Manning cites one interesting study where researchers tickled infants on their noses with a feather. Their responses ranged widely: Some infants didn’t react at all, others moved around and still others started crying and it was tough to calm them down. These babies were seen as sensitive to emotional stimuli.

Like other disorders, BPD also involves an environmental component. (Not everyone whos emotionally sensitive goes on to have BPD.) Individuals with BPD aren’t just genetically vulnerable to emotions; they’ve also grown up in an invalidating environment. So they mightve never learned how to regulate their emotions, or their emotions were continuously ignored or dismissed.

What It Means To Be Emotional

According to Manning, being emotional isn’t a lack of control; it has more to do with three separate tendencies that cause emotional arousal in different ways. These are:

  • Emotional Sensitivity. Loved ones aren’t the only ones confused when someone with BPD has an emotional reaction seemingly out of nowhere. People with BPD may be unaware of the trigger, too. But they still have a strong reaction. Emotional sensitivity wires people to react to cues and to react to their reactions. Manning explains that: To understand emotional sensitivity, think of the person with BPD as being raw. His emotional nerve endings are exposed, and so he is acutely affected by anything emotional.
  • Emotional Reactivity. A person with BPD not only reacts with extreme emotion (what would be sadness in most becomes overwhelming despair. What would be anger becomes rage), but their behavior also is intense and doesn’t fit the situation. They might sleep for days, scream in public or self-harm. Manning points out that emotional reactivity isn’t self-indulgent or manipulative, which is an unfortunate myth attached to BPD. Instead, research has suggested that people with BPD have a higher emotional baseline. If most peoples emotional baseline is 20 on a 0 to 100 scale, then people with BPD are continuously at 80. What can intensify their reactions are the secondary emotions of shame and guilt because they know “their emotions are out of control, Manning writes. Lets say your loved one is angry. “On top of the original anger, these secondary emotions feel intolerable, and their fear of all this emotion, ironically, tends to fire off another series of emotions perhaps anger that is now shifted to you, for not helping your loved one or for some unexpressed reason.”
  • Slow Return to Baseline.” People with BPD also have a hard time calming down and stay upset longer than others without the disorder. And theres interesting evidence to back this up. “In a person with average emotional intensity, an emotion fires in the brain for around 12 seconds. There is evidence that in people with BPD emotions fire for 20 percent longer.”

An Exercise in Understanding

In Loving Someone with Borderline Personality Disorder, Manning also helps readers better understand what its like to be emotionally vulnerable. She suggests thinking about an extended period of time when you were very emotional.

For Manning her emotional explosion happened when the company she’d worked for was going bankrupt. Not only was everyone upset and Manning barely sleeping but then her friend passed away. At that point I felt like every emotion that I had was at the surface of my skin. I physically felt like I would explode with emotion if one more thing happened.” She notes that she was “an emotional sponge.” She didn’t even want sympathy because she felt like this would put her over the edge.

When thinking about your own highly emotional experience, Manning writes:

Remember what it felt like emotionally and physically. Remember how it felt like emotions were just building on each other. Remember the experience of no one understanding how bad the situation was and how emotional you were. Now tell yourself that this is the experience of your loved one every moment of every day.

How Loved Ones Can Help

Manning shared her insight on how family and friends can help in a two-part interview on Psych Central (Part 1 and Part 2). And loved ones can do a lot, especially when it comes to helping the person when they’re upset.

In her book, Manning provides readers with step-by-step strategies and detailed examples. Below is a brief list of suggestions from her book:

  1. Assess: ask what has happened.
  2. Listen actively; don’t contradict, judge, or say your loved one is overreacting.
  3. Validate: find something in what happened that makes sense and is understandable, that you can relate to; say what that is.
  4. Ask if you can help, not to solve the problem but to get through the moment.
  5. If your loved one says no, give him or her space and remember the emotions of emotionally vulnerable people last longer.

Also, it’s important to remember that people with BPD do get better and simply need to learn the skills of managing their emotions. While this requires hard work and effort, treatments such as dialectical behaviour therapy (DBT) have been shown to be highly effective.

(DBT) Dialectical Behavior Therapy for Borderline Personality Disorder  

Dialectical behavior therapy (DBT), developed by Marsha Linehan, Ph.D., at the University of Washington, is a type of psychotherapy, sometimes called “talk therapy,” used to treat borderline personality disorder (BPD). DBT is a form of cognitive behavioral therapy (CBT), meaning it’s a therapy that focuses on the role of cognition, which refers to thoughts and beliefs, and behavior, or actions, in the development and treatment of BPD.

DBT includes some changes to the traditional cognitive behavioral elements of therapy. These changes are intended to specifically help reduce the symptoms of BPD.

Research Support for Dialectical Behavior Therapy

DBT was the first psychotherapy shown to be effective in treating BPD in controlled clinical trials, the most rigorous type of clinical research. While DBT is no longer the only therapy to have shown effectiveness in controlled trials, it has grown a large evidence base and is considered one of the best treatments for BPD in terms of documented success rates.

Theoretical Basis for Dialectical Behavior Therapy

DBT is based on Dr. Linehan’s theory that the core problem in BPD is emotion dysregulation, which results from mixing biology, including genetic and other biological risk factors, and an emotionally unstable childhood environment, for instance where caregivers punish, trivialize or respond erratically to the child’s expression of emotion, together.

The focus of DBT is on helping the client learn and apply skills that will decrease emotion dysregulation and unhealthy attempts to cope with strong emotions.

What to Expect in Dialectical Behavior Therapy

Usually, DBT includes a combination of group skills training, individual psychotherapy and phone coaching, although there are exceptions.Patients in DBT are asked to monitor their symptoms and use of learned skills daily while their progress is tracked throughout therapy.

There are four main types of skills that are covered in DBT skills training. These are:

  • Mindfulness Meditation Skills. These skills center on learning to observe, describe and participate in all experiences, including thoughts, sensations, emotions and things happening externally in the environment, without judging these experiences as “good” or “bad.” These are considered core skills that are necessary in order to implement the other DBT skills successfully.
  • Interpersonal Effectiveness Skills. The focus of this skill module is on learning to successfully assert your needs and to manage conflict in relationships.
  • Distress Tolerance Skills. The distress tolerance skills module promotes learning ways to accept and tolerate distress without doing anything that will make the distress worse in the long run, for instance, engaging in self-harm.
  • Emotion Regulation Skills. In this module, patients learn to identify and manage emotional reactions.

Interested in Dialectical Behavior Therapy?

If you are interested in learning more about DBT, there are a number of resources available on the Behavioral Tech website. Visit the resources page to learn more about the basics of DBT and Dr. Linehan. The clinical resources directory can help you find DBT providers in your area.

Alternatively, you can ask your therapist, physician or other mental health professional for a referral to someone who specializes in DBT.

The Difference Between DBT and Didactic Therapy

Didactic therapy is a group therapy most often used for those with substance use disorders to teach them the facts and help educate them, while DBT is typically for use in the treatment of borderline personality disorder.

Id like to thank you for reading todays Blog on Unstable Emotions & Bonus, DBT.

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