What You Should Know If You Have Been Diagnosed With Borderline Personality Disorder

Here is the truth: BPD, or Borderline Personality Disorder, has a historically bad rap with mental health professionals. I’m going to give you some truths to what you should know to not only think about this clearly, but to consider your options in terms of the person you want to be and the person you want to become.

BPD was historically known for “bordering” on the lines of neurotic vs. psychotic. In the olden days, clinicians who didn’t know if a person was living in the confines of “reality” could put them in a category that didn’t really fit either one. Historically neurosis has to do with issues related to anxiety, mood, and depression. Neurosis can also be related to trauma, vigilance, and paranoia about bad things re-occurring. Psychosis is related to problems hearing and seeing things that others do not see or hear, and is often associated with schizophrenia. “Borderline” has often been referred to as a category that doesn’t really fit any category, and in some cases has been the in- between of no-place.

BPD is also historically written about from an extremely pejorative and hopeless point of view. Words like “manipulative, gamey, cagey” are often used, and mental health professionals often refer to this diagnosis when talking about people that bug them, that they do not like, that get them enraged, and people that can tie up crisis hotlines and emergency rooms. In many cases, labeling someone with BPD has become a substitute for observing and describing behavior, providing useful feedback, and encouraging people to behave in ways that make them competent and more effective.

Here are some truths that you should keep in mind if a mental health professional has “informed” you that you have BPD:

Mental health diagnoses are not valid nor reliable. This means that (in terms of validity), if the same professional assessed a person over time (such as an assessment 20 years ago, 10 years ago, and 5 years ago), the likelihood that that professional would give the same person the same diagnosis is unlikely. It also means that if many different mental health professionals assessed the same person it is highly unlikely the all of them would come to the same conclusion about diagnosis. This is assuming that the only measure of giving a diagnoses is a working familiarity with the DSM-TRV, or the “psychiatric Bible” of diagnostic criteria (which is highly controversial. Be aware that homosexuality was once considered a psychiatric disorder, and now it is not). Mental health diagnosis may be more reliable and valid if the diagnosis is given based on a range of valid and reliable assessment batteries; thus if you have had some comprehensive personality assessment and testing this may be less of the case for your situation. Bear in mind that most people in the counseling profession are doing nothing more than giving you their clinical opinion; hence my point about reliability and validity. Also, there are some counseling programs that don’t cover concepts such as instruments of mental health measurement.

For some mental health professionals, telling someone they have BPD can sometimes be a communication of frustration. In a helpful world, telling someone what diagnoses they have can be useful and even helpful- it can validate if a person really is depressed or help figure out specific treatments. In the case with BPD, the “right treatment” is more complicated and may not be readily available. If your mental health professional is telling you have BPD, you might want to consider: So what? How it is it helpful or useful? Does it help people have the resources or tools for solving painful problems? Is it specific enough to describe what behavior shows up- and how behavior can be changed? Does it provide access to literature that is actually helpful? For some people, being diagnosed with BPD can only serve to increase shame and self-loathing. Literature is not always helpful and mental health professionals don’t always shore up resources for how to move forward to obtain resources and supports. Is the expectation to hide in a corner the rest of your life and not tell people who you “really” are? And do you seriously want to live this way?

There is a lot of confusion for most people around diagnosis being a cause. Diagnoses are actually descriptions of behavior, and mainly identify patterns of responding or behaviors that are typical for a person. Many people, including some mental health professionals, actually believe that they are describing reasons or causes of behaviors when giving someone a diagnoses. For instance, if the way that you behave is because you have a disorder, then someone people think they have adequately not only explained the reasons you behave the way you do, but they think they know why you behave the way you do. In terms of diagnosis, this really is not the case. The failure of the mental health system is that people think they are being helpful (“You have problems because you have a disorder”) rather than addressing causes and potential solutions for behavior change. In this case, many problems of pain are not being solved as the focus of attention is on the “correct” diagnosis, which, in my opinion, is a rather useless pursuit. It can be akin to a parent who has several children; one of them is determined to be “bad.” Instead of figuring out how to prevent problem behavior, solve problems, and tend to the child’s needs; the parent simply attributes all problem behavior to the child being “bad.”

What you can do if you have, or think you have, or someone else thinks you have BPD:

Don’t think you are permanently impaired, hopeless, or beyond help. Fear and shame keeps may people paralyzed from acting with self-respect, doing things that are meaningful, and putting oneself out there in the universe. Universally, fear and shame can prevent anyone from living a decent life. You are not an exception.

Learn to talk about yourself and your behaviors in a descriptive, non-judgmental, and matter-of-fact ways. This will make you competent, understandable, and respectable. This also means that if you go around and tell everyone you are disordered, people may treat you as fragile, incompetent, incapable, or helpless. Create and practice ways to talk about yourself outside of the realm of “mental illness.”

Pay attention to providers, mental health professionals, or family members who attribute your behavior to being “mentally ill” or “bad” or “personality disordered.” Realize that everyone has vulnerabilities and that many, many people struggle with giving accurate, helpful, and specific feedback. Consider how giving and receiving feedback is either helpful or not helpful, and don’t seek out relationships where blame seems to be an acceptable solution for reducing pain or resolving differences. Finding “fault” only works if the consequence is taking responsibility and making changes; not amplifying shame and paralysis of action.

Be aware that if you do delve into literature on BPD, you may encounter a wide range of confusing terminology that attempts to define you; which may not only be disconcerting but also downright confusing. You might encounter terms like object relations, transference, countertransference, self-objects, self-soothing self-objects, object mirroring, intrapsychic processes, or projections. Don’t get bogged down by mental health-ese. Bear in mind that some mental health professionals have a lot of trouble observing and describing behavior and giving useful feedback and sometimes hide behind their own jargon.

Find other things that provide you a sense of identity, that define you, that make you the person you are, and that you value. Consider roles you take on in society; engage in them and be proud of them. What is important to you? Why would you let a diagnoses get in your way with pursuing what is important to you? In what ways do you not “show up” because you have shame around a diagnosis? Life is bigger than the world of “mental health.”

Bear in mind that many mental health professionals are obsessed with political leaders that they believe to be personality disordered. In truth, political leaders are still political leaders, and political leaders have made great gains, influenced many, changed laws, and maintained power. Being diagnosed with something “bad” hasn’t deterred people from being politically active, advocating, having power, or being influential. There is no good reason why you have to be shamed from participating in the universe just like everyone else- people with a lot of problems still manage to be successful and competent in a myriad of different ways.

Finally, feel free to visit the National Education Alliance for Borderline Personality Disorder, a nonprofit that may be more helpful than the general google search. Their website (www.borderlinepersonaltydisorder.com) has some useful non-pejorative literature, trainings, and free services for friends and family members.

Boston Area Depressed/ Anxious Adolescents: Why Should My Teenager Be In Group?

Teens face many developmental challenges throughout high school. Some of them are normative and stressful, and some of them become bigger than life overnight. Peer relationships can be life or death in terms of social isolation. Teens want to rely less on adults as they become more independent, but sometimes they get in over their heads.

Teens can be fine one moment and in crisis the next. Getting rejected on social media or having a shift in the friendship circle can imminently impact one’s desire and willingness to go to school and focus on schoolwork. Sometimes teens are fine.

And then, suddenly, they are not.

Ongoing group therapy presents a kind of “soft contact” where there are multiple prompts to talk about what is hard to talk about, rehearse ways of dealing with anxiety, and address “the thing” before it becomes a bigger “thing.” Some kids have a way of holding stress within, putting on a mask, and pretending things don’t bother them. Sometimes it is easier to dismiss how isolated one feels than to make a “big deal” out of something that shouldn’t be “all that bad.” One can spend a lot of energy trying to convince oneself that they are “okay” when really, they are not.

Ongoing group provides consistently, familiarity, and a stable peer cohort. If conflicts arise within their school, they can take it outside of school and gather advice about how to address it. Teens that tend to take on everyone else’s problems can be encouraged to consider their own needs, set limits, identify what they can and can not do, figure out their feelings, and communicate more clearly. They can learn to tolerate emotional discomfort more readily, be more prepared when conflicts come up, and stay in conversations that may bring up a lot of emotion. Being socially connected means hanging in there when things are hard- and sometimes being willing to give and receive feedback.

Being in an ongoing peer group creates opportunities for intimacy, growth, open sharing, and a way to hang in there together with people who are really struggling. It means learning how to address the awkward pause after an embarrassing moment, a tearful outburst, a shameful incident, or an expression of pain. It also means having some help for when someone just simply doesn’t know what to say or do.

In general, people tend to share more personal information with people who are familiar, available, and near- and whom they see regularly. When teens are having “a thing” that may “not be a thing” or “may become a thing”, and there is no consistent person to open up to, the “thing” that was “not a thing” can suddenly become a crisis. Teens are on the brink of engaging in risky behavior, relying more on peers and less on parents, and wanting to be independent. Telling mom or dad may seem childish and immature; yet teens need to do things that keep them safe.

Group is different than individual therapy because there are multiple perspectives in the room, peers can “get it” in ways that adults don’t always pay attention to, and there are lots of resources for help, feedback, and validation. Sometimes kids who are shy, self-conscious, and sensitive are missing out on real life connections- and this can keep kids isolated, ashamed, and lonely. While talking to an adult one one may be a source of comfort and relief, ongoing group therapy offers an entirely different context for problem solving and addressing anxiety.

For more information on teen groups, click here.

What’s The Fuss About? A Super Brief History Of Behaviorism, Cognitive Behavior Therapy, And What Is Really Meant By Third Wave Behavior Therapies.

Behavior therapies have been around for a long time in helping people address problems of depression and anxiety. Here is a short article about old ways of thinking about behaviorism and what newer “third wave” therapies have to offer.

Old behavior theories are often criticized for this idea that there is no “person” on the “inside”, rather everything was a matter of stimulus and response. For instance, the presence of a stop sign (stimulus) would prompt the behavior or stopping (response), and behavior could be controlled by stimulus in the environment. Criticisms of this way of thinking included the lack of free will or choice. Behaviorism in the current way of thinking would take into account learning history, which would explain how different persons have different responses to the same situations. It also takes into consideration how the context of the situation may influence the outcome, such as snowy weather conditions or the fact that a person was busily distracted with their cell phone when coming to the intersection.

Old paradigms of thinking about behaviorism include methodological behaviorism; the gist of it being that if behavior was not observed, it did not exist and was not worthy of study. Clearly this created problems for people who want to understand emotions. Current ways of thinking of behaviorism (radical as opposed to methodological) refutes the idea that behavior has to be publicly observed in order to exist. All the “stuff” that occurs within the skin (emotions!) are alive, real, in existence, and worthy of study. The more global way of understanding behavior is that any behavior is worthy of analysis and understanding. Thus, an emotion or a highly conflictual altercation (the stuff that comes up in therapy) is clearly worthy of study.

Cognitive Behavior Therapies (CBT) often emphasized the thought process that ensues when a person reacts to a situation. People have a tendency (especially when panicked or a in a bad mood) to think the worst will happen, jump to conclusions, and make assumptions about situations and people that are not accurate. Cognitive Behavior Therapies have often emphasized the thought process/ thinking/ cognition; and often challenged persons’s perceptions of reality. This can get tricky when dealing with paranoia, post-traumatic stress, or psychotic thought processes; and can create even more problems when people are told their perceptions of reality are not, indeed, real. Focusing solely on cognitive ways to solving problems can result in trying to think one’s way out of pain and discomfort, which sort of backfires when people have problems with rumination, over-analyzing, or overthinking. That being said, CBT has been helpful to numerous people and has had a key role in reducing suffering, depression, and anxiety.

Exposure therapies are often considered under the umbrella of cognitive behavior therapies and include specific treatment for anxiety disorders. This is where a person comes into contact with a feared stimulus and behaves differently from the typical response. The goal is to increase one’s tolerance to anxiety, increase the repertoire of responding adaptively, and not let feared stimuli control one’s life. Here are some typical examples of treating anxiety through exposures: Obsessive Compulsive Disorder (people that are disgusted by dirty things are encouraged to touch dirty things such that they become less bothered by dirty things over time: watch the move Dirty Filthy Love), Social Anxiety (people are encouraged to join a small group and share more openly than they otherwise would and feel less isolated and have better social abilities), and Borderline Personality Disorder (exposures help people tolerate emotions better such as practicing breathing when angry instead of ranting angrily or picking a fight).

Behavioral Activation is a treatment for depression that includes engaging people in life situations that increase natural reinforcers. In a nutshell, the behavior of depression is often one of detachment, withdrawal, inhibition of activity, loss, flatness, tearfulness, loss of focus, and sometimes aggravation. Activating behavior may include increasing pleasurable activity, engaging in meaningful behavior, doing things to build mastery and challenge oneself, managing stress and time management, and decreasing commitments that result in being overwhelmed. These are ways of managing mood that don’t include medication. (A really great book on this is Overcoming Depression One Step At A Time, which can be found under “books I recommend.”)

The newer behavior therapies or “Third Wave” therapies are often considered an offshoot of Cognitive Behavioral Therapy. Technically, behavior is given an emphasis over cognition. This is because behaviorists consider the thought process to be only one aspect of behavior and is not given any kind of special treatment. For political purposes (and for the general lay population) this distinction can be confusing and for some, probably not necessary. However, all behavior is open to analysis and one’s thought process is not the only focus of treatment. The idea of Third Wave therapies is a return to radical behaviorism (hence the analysis of behavior), an acknowledgement of the ways behaviorism has been both hurtful/ helpful/ misunderstood, and an expansion of how behavioral ways of thinking have been making phenomenal comebacks (and changes) on intimate, psychotherapeutic relationships.

Third Wave behavior therapies are different in that they are interested in two things: 1) Context and 2) Function. Behavior (which can include anything you want to analyze for the focus of your therapy session, such as an emotion) can happen anywhere in time and space. Current conditions (ie., the context under which behavior occurs) will influence behavior. Behavior does not happen in a vacuum and is not situationally isolated. It is fluid and subject to change. Consider how “repressed” memories “show up”, and if you more or less likely to remember repressed memories if you have a warm, caring therapist who is expressing curiosity about your past. How you remember, what you remember, and what you are willing to tell this person are all influenced by the current context. If, in your learning history, people are not to be trusted; a warm caring person asking you this personal information may result in you changing the subject or talking excessively. Learning history clearly plays a part in how a person will respond to a therapist, and again shows how the overly simplistic stimulus-response models of early behaviorism fall short.

The function of behavior has to do with the purpose it serves. The same behavior of two people can have very different purposes, show up in different settings or circumstances, and have different outcomes or consequences. The behavior of vomiting after eating (such as the case of bulimia) can serve to communicate, validate, express anger, maintain privacy, prove a point, assert independence, or prevent the discomfort of feeling full. The fact that the same behavior does different things for different people and has different consequences makes it such that two people with the same diagnosis can need very different treatments. This is partly why there is so much confusion and controversy over mental health diagnoses and their varying treatments, and why any one “template” approach doesn’t work the same way for any two people.

Third Wave Behavior therapies are also coming to terms with spirituality. While past therapies focused on making unwanted emotions/ thoughts etc. dissipate, new wave therapies are getting people to look at what they want more of, what they value, and what is important to them. Instead of saying “What do you want to avoid or get rid of in your life?” they are saying “What do you want more of in your life?” or “How are you missing out on what is important because anxiety/ depression gets in the way?” There is a renewed focus on mindfulness and acceptance and a recognition that painful thoughts and emotions are part of human existence.

We’ve worked really hard to eradicate pain and that hasn’t worked, so what can be done instead? Making peace with our discomfort by not letting anxiety and our depression control our life is done through some applied principles from Bhuddism, mindfulness, and the concept of being “zen.” Spirituality clearly has helped many people cope, come up with their “why”, and rely on powers outside of their control to help them survive emotional pain. (Ie., “Let go and let God”). The shift in Third Wave Therapies is to look towards a more expansive way of thinking and also addresses a more existential concern. You don’t have be clinically depressed to benefit from examining values, enhancing your quality of life, and growing as a person. And at least one of these treatments, ACT, is being used in non-psychotherapy settings such as organizational and business consulting. (The Association for Contextual and Behavioral Sciences is the umbrella organization of the growing interest in Third Wave Behavior therapies, and offer an annual international conference to interested parties. Click here to visit their website.)

Third Wave Behavior Therapies are generally considered to be Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), Functional Analytic Psychotherapy (FAP), and various mindfulness and compassion based therapies. DBT was somewhat of an early forerunner in bringing acceptance based practices to psychotherapy, the “dialectic” being that of acceptance vs. change. This was somewhat in response to the fact that Cognitive Behavior Therapy, despite the multitude of people that it helped, was a therapy based solely in principles of what needed to be changed. DBT skills include prayer, radical acceptance, finding meaning, and value-based goal setting. DBT’s founder, Marsha Linehan, grew up Catholic and developed the treatment based on her exposure to Eastern thinking and Bhuddism; she has written multiple articles on spirituality.

ACT is complex and a bit tricky to explain, but here are two principles that ACT encompasses: 1) Flexibility, or a flexible repertoire of responses to life’s challenges. A metaphor I heard recently was like a car hitting a pot hole- a car with no “bounce” or “give” is like a person who has difficulty adapting to life’s bumps. The more shock absorption that a car has, the more likely the car can navigate the pot holes and not get “tied up” or “stuck”. 2) Impermanence, or “self-as-context”. This means that the self that is “you” will change over time but still be the same “you”, and this “you” can change perspective in time and space. This matters in the sense that people who are really and truly “stuck” sometimes experiences their situations and self-criticism as permanent. The self-as-context concept often entails compassion focused exercises that allow you to see yourself differently; with compassion, and as an observer who can take a step back form being “fused” with emotional pain and rigid thought patterns. Compassion based practices have capitalized on the approach and address concerns related to extreme self-hatred, shame, and the ubiquity of human suffering. (Compassion Based Therapy is also considered it’s own independent treatment).

FAP at its heart has based its tenets on the principles of Awareness, Courage, and Love. (Known as the ACL model). Clients are encouraged to consider how their relational problems outside of session also show up inside of session, and to bring these similarities under direct observation as they show up in the relationship with the therapist. Immediacy (ie., What are you feeling right now as you are telling me this?) can evoke the discomfort clients often feel when in intimate situations, and encourage clients to develop more meaningful and fulfilling relationships via the interaction with their therapist. FAP is highly evocative, and clients grow in the courage to address things in therapy they tend to avoid. Because lack of intimacy is associated with mortality, intimacy and connection is a value that shows up consistently across FAP. If you think about this treatment from a behavioral standpoint, the environmental context (how a therapist responds) can have a profound influence on generating change. If the relationship with the therapist had no influence on the client, there would be no such thing as psychotherapy. Thus the focus on the environment (ie, the behavior of the therapist) is consistent with a behavioral approach to treatment.

The best way that I think of behaviorism is that there is no permanent, fixed, or reification of private experience such as thoughts, emotions, or sensations. The fluidity and impermanence of how we experience “self” changes across time, contexts, and situations. Problems often ensue when our thoughts are treated as structures, things, or objects. Problems crop up when we think we “have”, possess, or own the experiences within our skin. In order to “not have” depression, something would have change. Consider the difference between “having” depression vs. “experiencing” oneself as depressed. Which do you think is more hopeful, temporary, and subject to change? Third Wave Behaviorism, or “radical” behaviorism is making its comeback.

 

 

 

Are your socially anxious teens surviving school?

Socially anxious adolescents struggle in the presence of others. Some don’t know what to say, some become self-conscious, and some feel as if they have nothing to contribute. Others feel judged and go out of their way to avoid being the center of attention. Simple things like accidently dropping a pencil, asking to use the bathroom, or getting up to throw something in the trash are treated as a crisis. Social anxiety can create problems in other areas of life, including the inability to simply feel at peace with oneself in large groups, classrooms, and school.

The dilemma: Avoidance of social situations can result in isolation, loneliness, despair, depression, increased stress, and suicide risk. Approaching social situations, especially without confidence, can be downright painful. Classes may be skipped and grades may drop.

Individual services for social anxiety is a challenge: The task is to make a connection without overwhelming the individual. Sometimes teens find “therapy” downright painful. Sometimes it “works” for a short period, but teens also need to find their way within their own peer groups.

Groups allow teens to participate passively, contribute without disclosure, and to experiment with finding their voice. It is not all about them all of the time. What a perfect venue for providing a service that is indirect yet direct! While individual services are helpful for solving emotional problems, group services replicate reality more realistically than 1:1 services with an adult. If teens are in places where peers offer spontaneous interactions while brainstorming solutions to conflict and emotional problems, the teen will be exposed to what life could be like if they open up. The increased comfort of speaking up and participating will translate into other peer settings- including school and eventually work.

Feeling comfortable speaking up and finding one’s voice is a powerful thing!

Does your teen have debilitating social anxiety? Please don’t hesitate to contact me…

Boston DBT Parent Class: Parenting the Emotionally Extreme Teen

 How did this class help you? Here is the feedback from four parents who took the Spring 2015 class:

 

“To try and react better..To try and anticipate my daughter’s behavior triggers..try to find out what is causing the extremes and deal those triggers… By accepting emotions and where they are coming from; not to deny my emotions but they are there for a reason. To validate how I feel as well as my daughter. To be calmer. “- Parent 1

“To better understand my emotions, and that they have a purpose…To explore that purpose. Better able to identify escalation in my daughter. I’ve learned to buy time, to put some time in between responding to my daughter and others. What was most helpful was the overall impact of the course which has left me better equipped and more curious about DBT.” -Parent 2

“It made me more willing to bit my tongue, take a deep breath, and not focus on ‘fixing things’. Acceptance was important, both dealing with my own emotions and allowing for acceptance of my child’s emotions. Using mindfulness techniques to tone down my level of arousal was also important. Understanding that emotions might be valid but ineffective in some circumstances. I thought the (video content shown in class) outlined some very pragmatic examples and techniques.” -Parent 3

“To be more present with my emotion. To validate how I feel as well as my daughter. To be calmer, to think things through. Being able to listen to others’ experiences. Each class was built on each other. Have learned many skills to be more effective with my daughter.” -Parent 4

Please contact

drhoekstra@bostondbtgroups.com

 if you would like

more information about

upcoming classes.

Three things you need to know about anger: Is it mentally “healthy”?

The problem with figuring out if anger is “good” or “bad”; “healthy” or “unhealthy” doesn’t allow any opportunity to figure out what anger does, how it works, and why it makes sense.

Think of your living room couch. Is it a “good” couch or a “bad” couch? Wouldn’t it sort of depend on a bunch of different things- such as comfort, style, how old the couch is, how many people can fit on the couch, or if the couch actually suits you? Usually if a couch has a use, serves a purpose, or does what it is supposed to it is considered valuable. While it is possible that you are sick of your living room couch- perhaps you think it is time to get a new one- your couch may be necessary to hang on to for now. On the flip side, you may be very happy with your living room couch. This could make it more likeable and increase your tendency to say, “It is a good couch.”

Emotions- like anger- are like couches. Instead of thinking about anger as being “good” or “bad”, it is more important to consider the following:

How is anger serving a purpose, fulfilling a function, or doing something useful? Anger can function to communicate, get someone to back off or change behavior, or change a situation for the better. Think of it like a red flag, a signal, or a message.

Is the way in which the expression of anger is effective? In other words, is the way you communicate your anger working for you?  What a person can make use of their anger by being aware of it (experiencing, tolerating, and understanding what it does for them) it increases the opportunity for effective expression (ie, another person heard, understood, and responded accordingly). On the other side, ranting or attacking often hurts relationships and doesn’t always send a clear message about expectations or desired change.

What are the relationship consequences for how the anger is being expressed? Relationships at some point might undergo rifts, misunderstandings, and irritation. The ability for people to tolerate these things in relationships sometimes help people grow, initiate important discussions, and bring about change or intimacy. On the other hand, anger that is overly intense can damage relationships, hurt other people, or add insult to injury.

When individual therapy with adolescents doesn’t work

Individual outpatient therapy with adolescents can sometimes be limited in that

1) It can fall into Question and Answer sessions-losing the spontaneity and flow of a helpful interaction

2) Adolescents have shorter attention spans, and keeping them focused on painful topics on purpose can be, well, painful!

3) Sharing personal information with an adult you don’t know, but were paired up with because your parents are making you, doesn’t always have the desired results.

4) Adolescents aren’t necessarily going to do things differently because an adult is telling them to.

Group therapy has several advantages in that

1) Its members will be able to tell your daughter if they like it, how it is helpful, and what it has done for them.

2)  It is private (no one knows each other outside of the groups) and participation can be minimal (it doesn’t have to be about you all the time).

3) Group members can help each other think things through, make decisions, look at consequences, generate feedback, and put words on experiences in way that an adult provider may not be able to.

4) Talking about peer situations leads to identifying oneself in peer situations- thus what matters is sometimes brought up by someone other than yourself- or an adult, who may not have a clue.

(Hey! I’m not in high school anymore!)

Click here to see more on what group can do for your daughter. 

10 Reasons why you need The Emotional Extremist’s Guide to Handling Cartoon Elephants book this holiday season

1. The Cartoon Elephant book, after being temporarily unavailable through Amazon, is now back on the market. The retail price is $26.95, but sometimes Amazon will let it go for a bit less.

2. Cartoon Elephants approach painful emotions with humor. If there is an elephant in the room in your family, this book is the starting point for approaching avoided conversations. You will recognize yourself and others in this book. There is no finger pointing or blaming.
 
3. Cartoon Elephants is something you can put on your coffee table. Because it is a graphic book with pictures and fun fonts, it is an easy read. The elephants will fit nicely next to big picture books about Africa and Asia.
 
4. The Cartoon Elephant book is being used to teach people in Dialectical Behavior Therapy skills groups about emotions. Loaded with psycho-educational material and teaching points, it cleverly accomplishes the task of making people think they are reading something fun yet giving them something valuable.
 
5. This book is not hard to read. There is no “plugging away” at chapters. If you want to bring something to someone’s attention in a way that is universally applicable, this book will do the trick. You don’t need to have painful emotions to appreciate elephants- you just need to have emotions.
 
6. If you are going to buy someone a self-help book for Christmas, this is safe bet.
Whether they believe it or not, everyone has cartoon elephants. The research proving this to be true is cited in the back of the book.
 
7. This book can be used and re-used, read and re-read. You can share it with family members, friends, or long lost relatives. It won’t go out of style. Emotions, as a rule, will be with you as long as you live.
 
8. You will get some food for thought about how and where you see yourself in relationship to your elephants. This is great for discussion groups, weekend retreats, and writing workshops.
 
9. This book is great for people of all ages. If you’re trying to get your kid to read something important, heavy, and deep, you can give them this book. It won’t take long to read and it is much more fun with illustrations.
 
10. The book will be the perfect introduction for my live series on emotions starting January 20, 2014. Of course you don’t need the book to sign up, but if you have the book you will have a better appreciation for cartoon elephants in general.

 

 

Biological factors, physical well-being, and emotional vulnerability

One of the DBT skills for regulating emotions is to make yourself less prone to negative emotions by taking care of biological factors. This is because biological factors influence mood! How would your emotions change if you were doing everything you could (biologically) could to take care of yourself? The point is that you may be able to get positive moods to stay around longer, be less impacted by negative emotions, or have more of a “buffer” or “thicker skin” when life stressors come along. Eating regularly, exercising, developing good sleeping habits, treating illness or pain, and avoiding mood altering drugs are the skills for reducing emotional vulnerability.

Consider this: Go back to the last incident in which you reacted strongly, did or said something you regret, or behaved in an extreme fashion. Can you identify any biological factors that may have been going on before that incident happened? For instance, did you skip breakfast or have overwhelming stressors prior to the incident? Was your sleep off? Was it extremely hot outside- and could this have impacted your mood? Were you feeling physically exhausted, ill, or had some other kind of pain? Did you feel burdened or maxed out in terms of your well-being? Did you have a headache at the time?

If this is the case for you, you may want to consider one thing you might be able to change. For instance, if you know you are going to have a stressful interaction with someone, can you make sure that you don’t do it on an empty stomach? Can you plan to get exercise before or after the interaction? Can you do anything to get a good night’s sleep the day before? Can you plan to have the interaction in an environment that isn’t noisy, stressful, hot, or intrusive? Can you do anything to make sure that you don’t have or get a headache or have other physical concerns going on prior to the interaction? Can you plan ahead to ensure that the interaction is time limited? Consider how emotional energy takes it toll on your body, and treat your body well.

Biological factors may not solve all the problems- but sometimes they can be overlooked. If you could do one small thing to address your physical well being (and help you survive your emotions), what would it be?