How to change the behavior of someone you care about deeply

First, acknowledge what you cannot control. When others do things that are destructive, hurtful, irritating, annoying, or have painful consequences, the acknowledgement itself is simply a way in which you are looking and seeing what is actually going on. Not wanting something to be true, ignoring the fact that it is happening, attacking the person for the behavior, and making threats often reflects an inability to accept and acknowledge what is there. Often people don’t want to accept reality because it means something very painful. The acceptance of what is and the acknowledgement of what you cannot control can lessen the drama around the fight. It can also get people unstuck from repetitive impasses. However, it often means grieving what has been lost.

Next, do something for the relationship itself. Having a strong relationship will make you much more powerful and influential than having a rocky or weak relationship. One way to do this is to focus on what you appreciate, value, or like about the other person. Make it a point to express this directly. Another way to do this is to create time together in which you actively listen to what the other person has to say. Don’t interrupt or disagree- instead, just see if you can focus on understanding how they see things. Pay attention carefully to thoughts, experiences, feelings, and opinions. See if you acknowledge how they see things- even if you don’t see them that way. You may want to simply reflect and summarize what they are saying, and use statements like “If I understand you correctly…” Try to be gentle, warm, and receptive. Temporarily suspend efforts to fix or control their behavior.

Finally- if you desperately want them to stop doing something that is hurtful- focus on naturally occurring consequences of their behavior. When you try to control or change someone’s behaviors by threatening, being coercive, or being cold and withholding, it could really damage the relationship. Be direct in expressing your own feelings and reactions about their behavior- without making threats. You will be more powerful and influential when the relationship is strong, spending time with the person is a pleasant experience, and you are liked. Therefore, treat the other person as capable of choosing. Treat them as an equal. When they are fully aware of the realistic, natural, unwanted and painful consequences of their actions, their options for choosing increase. Consider your role as an ally who helps them think through their actions. There will be a big difference between (you) trying to control the outcome through threat or coercion vs. (them) having to face what they are doing and figure out what they want to do about it.

Repeat the steps. Sometimes you will be able to accept and sometimes you will not. Practice acknowledgment of what you cannot control over and over again. Build the relationship. You don’t have to ignore to deny what they are doing. You just have to have a way to address it in such a way that your voice matters, you don’t lose your own self-respect, and you don’t lose sight of what is important.

Too needy? Too dependent? Too clingy?

When we desire or want things that other people aren’t able to give us, one option is to blame ourselves for wanting or desiring it in the first place. This can be especially true for people who feel misunderstood or unacknowledged.

When we blame ourselves for wanting or needing something from someone else, we not only fail to solve any problems- but also feel worse for being in this situation in the first place. Sometimes people believe that by determining fault they’ve actually solved a problem! The field of psychotherapy confuses this issue even further by using condescending labels like narcissistic and entitled, and implies that it is simply bad to want or need things in the first place.

If you have been in the business recently of sitting around, feeling bad, and blaming yourself for desiring something from another, here are a few things to consider that might help your relationships go more smoothly:

1) Are you clear about what it is you want in the relationship that you aren’t getting? Consider the intensity behind your request and the urgency of how you come across. Is there any particular pain involved that you are trying to avoid feeling, don’t want to accept, or don’t think you will be able to tolerate if the person can’t accommodate you? Sometimes urgency and intensity is increased when we don’t want to grieve, acknowledge our own loss regarding the relationship, or move on.

2) Consider that no one relationship can placate or accommodate all demands for affection equally. Intense and intimate relationships need periodic breaks. Is there a way in which your relationships complement different areas of need for you? Is there a way in which your need for affection, acknowledgement, or understanding can happen with more than one person?

3) Consider the diversity in which people in your life express caring, show appreciation, or give their support. See if there is a way you can focus on acknowledging this, and be willing to let go of focusing on what the person isn’t giving you.

4) Bear in mind that all people need and want things from other people: The ones who don’t get called narcissistic or entitled simply have ways of getting it effectively. One way of being effective is being able to read and interpret interpersonal cues accurately. If you know when to back off- and you are good at gaging what other people can tolerate- you will be easier to get along with and better liked. Forcing a square peg through a round hole in any relationship can hurt or even destroy the relationship.

5) Not having affection, acknowledgement, validation, or understanding now doesn’t mean that you will never have it or no one will ever give it. It may mean that you have to search around for it, you need to find it in other relationships- and you may have to tolerate the emotional pain of not having it right now.

What does mindfulness have to do with validation?

Mindfulness involves an ability to “get in touch” and be aware of experiences that are both going on inside (ie, feelings) and the outside.

In DBT, the ability to validate means not dismissing or attacking oneself. Self-validating is about paying careful attention to what is present in the moment; true, accurate, and real.  It’s about looking at how you do feel, rather than how you should feel or are supposed to feel. This involves a focus on internal experience and physical sensations. It means figuring out what’s really there- even when it is confusing.

People with extreme emotional reactivity often have difficulty believing that their opinions, attitudes, values, and perspectives count. They may spend a lot of energy worrying, not speaking up, or even attacking themselves for having a different perspective. They may have difficulty when asked about intentions, wants, or desires. In some cases they may be used to not offering input. They may have adapted to not expressing intentions or wants. They may be living most of their lives not really existing, or at least existing on the periphery of what their lives could be.

Are you someone who has a hard time figuring out what’s going on within?

The 30 (more) days of mindfulness program offers many options in finding ways ways to be in touch…to be mindful…and to increase awareness of that which is within and that which is on the outside.

It is just about finished! I hope to have it available by the end of next week. If you want mindful options to arrive in your e-mail inbox for 30 (more!) days, and if you’ve already tried the initial (30) days of mindfulness, you will not be disappointed.

Stay tuned!

How to deal with angry people

If you are uncomfortable around angry people, don’t know what to do or say when other people express anger, are quick to avoid angry people, or become desperately eager to change the subject when the tone of the situation shifts to anger- then this blog post is for you.

First, if someone is very angry with you it is usually helpful if they are direct in their expression of their anger. It is much harder to address and solve problems when people are angry but will go out of their way to minimize, avoid, diminish, or deny that they are upset. When you know exactly what is in front of you, you will be able to figure out what you can and cannot do about it.

If someone is willing to be direct in their expression of anger, first try to simply understand what it is they are saying. This can be extremely difficult because if your integrity is threatened (or if you feel under attack) you will likely come across as guarded and defensive. It is hard to listen attentively and try to get accurate facts when emotional arousal is high. Conversations with angry people can be difficult, but if you can get through them skillfully you will be better equipped to navigate emotionally charged situations in the future.

Try to them to clarify what it is they expect, want, or anticipate happening. It is sometimes the case that people who are expressing anger are so emotional that they are not at all clear about what they want, what they expect, or what it is they are asking. If you are being attacked or criticized, try to diminish personal attacks and guide them towards stating their intentions or desires clearly. If personal attacks continue, you may want to suggest revisiting the conversation when they are done attacking you and are ready to work on problem solving.

Skills for clarification and understanding might include 1) summarizing what they are saying 2) asking them for correction or clarification 3) being willing to let them clarify or correct you. See if there is anything that might make sense from their point of view despite holding a different point of view. This may take multiple tries- and you may need to repeat these skills frequently throughout any one conversation.

Consider the intensity of emotional arousal. If a person feels as if someone is taking them seriously, listening, and working to understand them; their arousal will likely go down. When arousal is low enough for problem solving, then problem solving is much easier!

Next, realistically assess what can and cannot be changed and address the consequences. What can you possibly do to accommodate their request? What might you be willing to do differently? If you are a parent, supervisor, or other person in authority it is possible that you will not be able or willing to accommodate their request. Be honest and realistic with what you can and cannot do. Be gentle in laying out the facts for them. If they are still having difficulty accepting your decision, you may want to acknowledge disappointment, help them work on acceptance or alternative solutions, or encourage them to solve the problem differently. By doing this, you are showing that you are attentive to their concerns, care about the relationship itself, and can possibly be a resource when future conflicts occur. Hopefully you will have navigated an emotionally charged interaction without avoiding it, openly explored what could and could not be changed, and demonstrated that strong emotions can be tolerated without destroying the relationship.

The particular sadness of lemon cake by Aimee Bender

Recently I read this novel and started thinking about the ways in which sensitive people have access to sensory information that the rest of the world doesn’t have, doesn’t pay attention to, or isn’t bothered by. The particular sadness of lemon cake is about a young woman to tastes other people’s emotions when she eats foods that they have made. Being able to access these experiences gives her all sorts of information that she doesn’t necessarily want- or know what to do with.

I think that sensitive and observant people often pick up on emotional tones, nuances, shifts in energy, and other aspects of behavior that not everyone sees. Knowing where to take this information, what to do with this information, and figuring out how to use it wisely can involve some growing pains. Some of the people that I treat have tendency to dismiss, attack, or hate themselves for having access to it in the first place. The character in The particular sadness of lemon cake even goes through a period of time in which wants nothing to do with her mouth.

Emotional sensitivity can be seen as a gift. Being reactive, tuned in, and responsive to others’ emotions can be difficult and painful- especially if people in the environment don’t get what you get. Instead of hating yourself for having the information in the first place, consider what you might do with the information.

Being perceptive and picking up on things that others aren’t picking up on doesn’t necessarily mean that you have to react or say something in the moment. It may be noticed, attended to, or worthy of discussion down the road. How do you think what you notice about other people that they don’t notice about themselves could be useful information? If you had this information and you wanted to respond to it in such a way that you felt good about yourself, how might this information help you 1) give someone accurate, meaningful, and relevant feedback 2) help you keep a relationship by (possibly) not saying anything- or by waiting and finding the right time to say something? In any case, consider a stance of openness and curiosity: What could it mean for yourself and the relationship?

Are you in touch with your true cartoons?

In DBT, primary emotions are emotions that people have about a situation or event. Secondary emotions are emotional reactions to emotions. Figuring out which is which may be helpful for people that have a lot of trouble sorting out what they feel, identifying what causes feelings, and knowing how to make use of feelings. The overall goal is to enable people to express emotions accurately.

Let’s take the example of anger. Sometimes, when people get angry, they say things they do not mean. They deliver “low blows”, say things that are extremely hurtful, and launch into full attack mode.When anger shows up, it is very possible that other primary emotions (betrayal, hurt, scared, or sad) are also part of the picture.

Imagine how the conversation would be different if the person who expresses anger was actually expressing any of the above emotions. “I was really upset when you didn’t show up. I thought something might have happened. At first I was really worried, and then I started thinking that you might have forgotten about meeting with me altogether. I wasn’t really sure what to make of the situation. I have this tendency to think no one cares about me when this happens. Perhaps you could tell me what happened.”

Another example may go something like this: Feeling afraid but then feeling ashamed for feeling afraid. Sometimes people are afraid of intimacy and connection but act on the shame. For instance, having a really good time with friends (feeling appreciated, included, and valued) is followed by withdrawal and avoidance. Is this you? If so, what words would you put on your fear that would be more accurate? Are there any elephants in the room that you’ve failed to consider?

 

Slow down, get clear, and become organized

Knowing what you want gives you the power to ask for it, to look for what you want, and to get what you want from the people who are willing and capable of giving it.

Lots of things get in the way with our ability to be effective. Often intense anxiety keeps our focus on the immediate threat. Sometimes this means rehearsing or imagining the worst possible outcomes over and over again. Sometimes our anxiety propels us towards anxiety-driven action. We are prompted to immediately fix, appease, accommodate, or even attack. Sometimes this causes us to lose sight of ourselves, become unglued, or to become disorganized. We stop looking at our expectations, desired outcomes, or even our unique observations. We don’t think about unintended consequences of our behavior on our relationships. We can become busy accommodating everyone else’s expectations to the point of exhaustion- often to find that other people continue to be dissatisfied.

Take a minute to consider what you want, think, notice, and feel. Consider if what you want might include: Being heard, being taken seriously, being respected, or being acknowledged.

Sometimes change involves a loss or regret that another person is not willing or capable of giving you what you want. But instead of getting into a crisis over it, this clarity allows you to re-consider your options, change the way you are asking for it, tolerate the limits of others, or even move on- and possibly keep looking for it from someone who can give it.

When my clients get better, the changes I observe are quite noticeable. Often there is a shift in energy- a slowing down.  They appear more confident as they become centered, calm, and clear. They get organized! They are less prone to non-useful conflicts and increase their ability to steer clear of unwanted chaos.

Why consider the function of behavior?

People sometimes behave in ways that are not understandable! Extreme and out-of-control behaviors can result in relationship ruptures and endings,  strain, awkwardness, discomfort, and avoidance of talking about “what happened.”

The function of a behavior has to do with the purpose that the behavior serves for a person. Often confusing, problematic, and egregious behaviors have some benefit for a person.

Some functions of extreme behaviors may include: Emphasizing a point, communicating the importance of something, making a statement, expressing outrage or protest, being taken seriously, reducing anxiety, feeling reassured or calmed down, feeling cared about or secure about the future, feeling *something*, being independent, having a say in a situation, being included, or letting someone know that something is important or meaningful.

Understanding function often helps people to problem-solve, to communicate more effectively, to be able to validate experience, to let go of situations or relationships that won’t change, and to find compassion for self and others.

 

Are clients with Borderline Personality Disorder too needy? Follow up thoughts from attending the NEA BPD conference.

This past week I attended a conference hosted by the National Education Alliance for Borderline Personality Disorder. Dr. Alan Fruzetti presented on Dialectical Behavior Therapy and Dr. Anothony Bateman presented on Mentalization Based Treatment (an alternative treatment for BPD). Then they both did a “role play” of a session (with the same client and same presenting concerns)- each demonstrating the theory and application of the treatment they represented. It was a wonderful opportunity to see two very skilled clinicians at work.

During the role play, the acting client identified a great deal of difficulty when her boyfriend suggested that he did not want to “cuddle” with her- as he wanted to “take things slowly.” She expressed a great deal of distress about this situation- including thoughts of suicide.

At the end of the role play, Dr. Fruzetti asked the audience if they believed that the client was “too needy.” Several people raised their hands. He then suggested that he did not believe the client to be “too needy.”

I really appreciated that he did this- mainly because of the stigma in the field around borderline personality disorder and neediness. Having, wanting, needing, or desiring things in the first place has somehow been interpreted as pathological and problematic- and gets punished. (“It should not be as it is. You should not be as upset as you are.”) It also seems to defy self-acceptance. Clients often have some deal of difficulty sorting out confusion regarding self-experience (ie, not feeling real, confusions about experience and feelings, acting or behaving in ways that are inconsistent with intentions). It seems that pathologizing the wanting only makes things more confusing- and creates more problems- and I regret that it is so common in the mental health field to do so.

Being clear about what is wanted is a sign of improvement. Knowing adaptive and effective ways of getting it involves skill. Attacking oneself for wanting or desiring something in the first place is not an effective way of solving a problem. In addition, attacking oneself for wanting or needing things in the first place reinforces this idea that reality should not be as it is. Accepting how things are also involves acceptance of oneself- even though wanting something very badly can be painful.

Renee’s 27 stages of change:

1. Be reminded on some gut level of why you want or need to change
2. Avoid everything related to changing
3. Consider those who have changed
4. Compare yourself to those whose lives are different
5. Attack yourself for not changing
6. Start to take the first step towards change
7. Become overwhelmed
8. Wallow a bit
9. Consider the benefits of change
10. Get motivated or inspired by others whose lives are different
11. Be reminded on some gut level of how things are miserable for you now
12. Ask for help
13. Experience a sense of efficacy or encouragement
14. Experience a setback or discouragement
15. Try again
16. Become overwhelmed
17. Avoid people and places reminding you of change, at least for a while
18. Give up
19. Try again
20. Get reminded of how miserable you are
21. Approach everything that you’ve tried to avoid
22. Get overwhelmed
23. Take a small step and stick with it
24. Notice the pros and cons of the small step
25. Rant and rave to other people in your life about how things aren’t working
26. Try to get help again
27. Get motivated, take another step.
Etc. Etc. Etc.

Don’t kid yourself.
This is hard work.
We’ve all been there.