Understanding and Helping a Borderline

Image: FreeDigitalPhotos.net

 During a Crisis

Encourage  them to use crisis skills,see my Crisis Skills Post 

Things I will be discussing today are:(compulsive)self-harm,things to do/say,things to avoid and tips for friends/family of a borderline.

Top 25 Things NOT to Say (or do) to Someone in Crisis

By Lisa Dietz from dbtselfhelp.com

				1. Tell them to stop thinking about the past. 2. Try to relate to them by comparing what they are telling you to your own experience like the time when your purse was stolen or you went through your divorce. 3. Use what they are saying as an invitation to talk about how bad you're feeling. 4. Tell them that everything happens for a reason. 5. Walk away, hang up the phone, or laugh. 6. Tell them how strange/foolish/crazy they are to feel or think such things. 7. Invite them to have sex. 8. Interrupt them to tell a funny story about your cat. 9. Tell them they couldn't possibly be feeling or doing or thinking whatever they just told you. 10. Tell them that their feelings are silly, meaningless or inappropriate. 11. Try to solve their problems for them. 12. Tell them to pray to Jesus. 13. Ask them lots of questions about their past. 14. Tell them to "pick themselves up by the bootstraps" and get on with life. 15. Tell them to talk to a psychiatrist (so you don't have to listen). 16. Try to cheer them up by telling jokes or uplifting stories. 17. Offer them a drink (alcoholic). 18. Tell them how much better you would have handled the situation. 19. Tell them that whatever they're upset about or whatever they have experienced is God's will. 20. Dramatize their pain by being shocked at everything they say. 21. Give them unsolicited advice. 22. Pretend they're not really in crisis and change the subject. 23. Tell them that they're letting their imagination run wild. 24. Compare what they're telling you to other people you know who are crazy, hospitalized, manic, schizophrenic, and/or dead (especially when they've committed suicide). 25. Tell them that someday they'll look back at this and laugh. Most of all do NOT tell them to go kill themselves.that mark will stay with them a long time if not forever.Honestly would you like someone telling you that you mean nothing to them & would help everybody else by being dead? Things to do  Regulate your own emotions so you can deal with the situation & think more clearly.  If the person starts calling themselves names... do not tell them the exact opposite or that they are a %/&¤#! ,as it may cause more distress.Try to validate in an appropriate tone (no accent on feel or the insult...) the feelings instead that are causing them these thoughts eg "I know you feel bad about how you acted... and it makes you feel & think you are a bad person"  Ask what emotions they are experiencing if they are able to express this. Ask how you can help (if  you are willing to do this)   After a crisis when the person has calmed down,ask them if you said anything in particular that was unhelpful.That if they are afraid to say it that they can choose to write it and give it to you when they have reflected on it,if they are willing. Try not to re-enforce the suicidal behaviour.This happens by giving the person extra attention & rewards that usual when that person is doing well.If you think you are  reinforcing suicidal behaviour talk to a cognitive behavioural therapist.Create an alternative plan with your loved ones that reinforce non-suicidal behaviour. If you are ever in doubt, call a professional. Communicate your faith in your loved one’s ability to get through the crisis.

Tips for Friends and Family of Someone with Borderline Personality Disorder

It can be difficult to deal with a friend or loved one who has borderline personality disorder (BDP). Use these tips to handle tough times and help maintain a safe environment:

• Read as much as you can about BPD — knowing about the disorder helps you deal with it,join a support group or seek help from a therapist for yourself.Look after your mental & physical health,try not to isolate yourself.
•  Encourage your loved one to seek treatment.Attend therapy sessions you are invited to,learn about the BPD's therapy plan and how you are involved in it.
• Understand that BPD behaviors aren't about you. 
• Try to remember your loved one's triggers & avoid them,don't expect it to work completely.
• Don't allow yourself to be abused.
• Exiting the room during an argument excusing yourself politely to continue the conversation when emotions have gone down is a helpful approach.
• Don't expect medications to fix the problem 100%.
• Learn how to cope during a crisis and how to regulate your own emotions.
• Try to be consistent in your behaviour.(don't give in and allow something today and forbid it tomorrow)

Self Harm

Self harm can be a confusing idea to grasp for people who have never experienced these urges.It can appear in many different forms (see Crisis Skills, Bad Coping Skills and Self Harm  for more info)

A very good explanations is found here : http://www.dbtselfhelp.com/html/managing_deliberate_self_harm.html

Below is an extract.

Contrary to popular belief, deliberate self-harm is not usually an attempt to manipulate others. Nor is it usually a ‘cry for help’. Most people are quite able to ask for help without self-harming and the secrecy that often accompanies self-harm demonstrates that something else is going on. That ‘something’ is known as ‘Dysthymia’.

Many people, particularly those diagnosed with Post-Traumatic Stress Disorder or Borderline Personality Disorder experience emotions in a particular way (Kroll J. 1988). When under pressure they may find it impossible to make sense of what they feel and become ‘Dysthymic’. This means that they experience all emotions at the same time but no single emotion in particular. This, understandably enough, is difficult to bear.

One way to ‘reset’ the emotional balance is through physical pain. Self-harm prompts the brain to produce endorphins, a kind of natural opiate, which overcomes Dysthymia and allows the person to feel better. So when a resident deliberately self-harms it’s likely that they’re feeling stressed and overwhelmed. It doesn’t matter how stressful others believe their situation to be. Different people have different coping abilities and what may be no problem at all for one person might well overwhelm another (Zubin & Spring 1977).

Self-harm can be done for many other reasons.Abandonment/fear of abandonment pain,suicidal urges,urge to do something drastic as emotions seem overwhelming,to give in to the urge so it will go away,as punishment,to deal with self-hate.It helps you calm down quite quickly from a crisis,to feel something during unpleasant dissociation & to break out of this dissociation,to reduce anxiety,obsession with blood,distract oneself,make bad memories fade.

Compulsive self Harm

Can include hair pulling/tweezing (trichotillomania),biting,skin picking and excoriation when done to remove perceived faults &/or blemishes on one's skin.They can occur as an OCD ritual,but not always.An OCD ritual obsessive consists of thoughts followed by the behavior as a way to relieve the tension & prevent something negative from happening by doing these self harm-behaviours.

Help can be found here:

http://stoppickingonme.com/bb/

http://www.ocdla.com/dermatillomania-compulsive-skin-picking-test.html

http://www.trich.org/treatment/article-inositol-penzel.html
Treatment for skin picking

Personally I have found inositol (consult your doctor due to possible medication interactions...) to be very helpful for reducing my urges to pick at my skin & pull out my hair.These behaviours may also be done when bored.Swansons have a nice 227g box which is cheaper than other powder boxes.True Hope also have a finer powder also 227(but will last longer than the Swansons box)


Sources :http://psychcentral.com/lib/2011/how-to-help-a-loved-one-with-borderline-personality-disorder-part-2/
http://www.dummies.com/how-to/content/borderline-personality-disorder-for-dummies-cheat-.html
my head  &experience =P