The Impact of Borderline Personality Disorder on Relationships

All too often, family members, friends, fellow employees, and even therapists become reactive, judgmental, and walk on egg shells when they interact with someone who displays characteristics of borderline personality disorder.  Let me start off by summarizing some of the core characteristics of the disorder, specifically focusing on those traits which play out in the interactions with others.

  1. Affective Instability – This is where those with BPD struggle to regulate their emotions in predictable ways.  Often, their mood does not match with expected life or social situations, thus making it difficult for those around them to understand or relate to the distress they are experiencing.
  2. Fear of real or imagined abandonment – Those struggling with BPD are often afraid of being rejected, abandoned, or left alone emotionally. These feelings are triggered when the potential abandonment is indicated, as well as times where it isn’t.
  3. Identity disturbance – It can be difficult for those with BPD to maintain a consistent sense of self. There is typically a variance of self-doubt, instability in self-image, and self-acceptance.
  4. Impulsivity – Due to the emotional and personal instability, impulsivity is often a regular occurrence for those with BPD. While this may not feel disruptive for the individual, it can be highly disruptive for those around them.
  5. Paranoid ideation and dissociative symptoms – In certain situations, those with BPD may struggle with feeling paranoid, especially in relation to how they perceive other’s intentions or motives. Also, they may experience dissociative symptoms, which is a disconnect from themselves, their reality, or their sense of self.

What we need to understand about personality disorders is that they are just that, disorders which occur within the core personality of the individual.  This is important to consider, because it is extremely threatening to the individual when a personality disorder is suggested, or when a diagnosis is made, especially since it is difficult to be “objective” about your own personality.  Because of this, it can be very threatening for someone experiencing symptoms of BPD to identify and accept that the symptoms are present in their life.

It is my professional belief that the symptoms of BPD are treatable, and that through treatment, people can reduce the identified symptoms to the degree that they no longer qualify for the diagnosis.  This perspective can bring hope to those struggling with BPD, as well as those who are involved in their life.  However, the process of therapy can be challenging, and typically requires long term treatment.

Selecting a therapist who can treat BPD effectively is an important step in the process.  The therapist must be able to accurately diagnose the disorder, as well as position themselves in the therapeutic relationship as to control for and manage the identified symptoms.  A careful balance between soliciting BPD symptoms and maintaining safety and security within the therapeutic relationship is critical.  Failure to challenge the BPD symptoms results in no change, while doing so without carefully creating a safe therapeutic relationship will typically result in early or even immediate rejection on the part of the client.

Once someone with BPD can effectively accept the diagnosis, identify how the symptoms play out in their life, and learn new ways of managing and responding to the symptoms, then they can focus on the primary relationships in their life, and work on how they relate to others in new ways.

Written by Dr. Tony Alonzo, DMFT, LMFT, CFLE therapist at the Holladay Center for Couples and Families

Cleaning Out Your Marriage Closet – Couples Counseling

People are often worried about drudging up the past with their loved ones. There is controversy as to what is healthy for the relationship. People certainly don’t like to bring up an old fight when everything is going well. The issue is that we all have a closet of sorts where we hide everything that “isn’t worth the fight.” At first this closet is empty and the intention of putting things in there is good, you intend to talk about it later, it’s just not the right time.

The problem is that you enjoy the times you’re not fighting, who wouldn’t! You soon forget about what you’re storing in the closet, and you continue to throw everything “not worth the fight” into the closet. Your closet becomes full, and when you try to fit one more thing in there everything topples over. This is the fight of all fights, this is when you seemingly “loose it” out of nowhere about nothing and everything. This fight happens at a time when something was already “not worth the fight” and you were trying to put it in the closet. Therefore, you are probably not up for resolving everything in that closet either. It’s like if your junk closet toppled over just as company is coming over, you’re going to scoop everything up and stuff it back into the closet because you don’t have time to sort through it. This fight leaves everyone upset and confused and often nothing is resolved in this fight.

So how does one clean out this closet? Well its much like spring cleaning, you are going to take everything out and you begin to sort everything into categories. You evaluate if it is something that only happened once and will never happen again, if this is the case it truly isn’t worth the fight and can be thrown out. If it is something that continues to happen you need to address it, you will be bringing up the past not as a weapon against the other person, but as a justification for bringing it up as an issue. It is absolutely necessary that cleaning this closet is done at a time when your calm and you remain calm to be able to assess what the core of the problem is, what does their behavior tell you about your relationship with them. For instance, If someone is always late, how does their behavior effect you, why does it feel disrespectful to you and how does it create distance in your relationship, what is the message you receive about their feelings toward you. As opposed to judging their behavior as something you wouldn’t do and lecturing them about how it affects them.

When you clean out the closet you are transferring responsibility to the people it will be useful with. You will find that the cleaner your closet becomes the more clarity you will have in your relationships. Your intent in cleaning out the closet is not to change other people’s behavior, it is meant to change your relationships. You will find that some people will choose to become more distant because they are unwilling to make changes, but the relationships that become closer and the internal peace will be worth the distance in others.

Written by Madison Price, MS, LAMFT – therapist at Holladay Center for Couples and Families

Why Couples Therapy Often Fails

Couples often start therapy years after they first need it. I work with couples who tell me about their struggles years before they end up in my office. Its sad to hear how they saw the need for help, but didn’t get it for one reason or another. I hear them talk about things they try, reading books, talking with church leaders, trying harder, date nights…to no avail. There is nothing wrong with these types of activities as they do help strengthen a marriage. The problem is that the couple needs more fundamental healing and work. They need a solid relationship foundation (i.e., secure attachment, emotional safety), not a superficial fix (i.e., date night).

Here is what I tell these couples – start focusing on yours and your spouses emotional needs and experiences. Most couples struggle to do this because it is scary and unfamiliar. Understanding what your emotional needs are helps you to know what to communicate with your spouse. The trick is, at that point, communicating those needs in an appropriate manner. Extending an Invitation rather than an Demand regarding these needs is important. Invite your spouse to understand your needs and collaborate with you how to get them met. The more you then do this for your spouse the better your relationship will be. Understanding their needs and trying to meet them will help them feel safe and secure in your relationship and give them the ability to do this for you. This can be a difficult experience for both of you. Its scary to be that vulnerable and exposed with your spouse. No one else can hurt you like they can in this world. Opening up in this manner requires that you trust them to take care of you and be soft and caring. Them opening up in this manner requires the same type of trust in you.

A couples counselor can help you learn to be that vulnerable with each other while maintaining emotional safety.

By Dr. Triston Morgan, LMFT

Hidden Signs of Depression

Studies show about 1 out of every 6 adults will have depression at some time in their life. This means that you probably know someone who is depressed or may become depressed at some point. We often think of a depressed person as someone who is sad or melancholy. However, there are other signs of depression that can be a little more difficult to detect.  

Trouble Sleeping 

If you notice a change in a loved one’s sleeping habits pay close attention as this could be a sign of depression. Oftentimes depression leads to trouble sleeping and lack of sleep can also lead to depression.

Quick to Anger
When a person is depressed even everyday challenges can seem more difficult or even impossible to manage which often leads to increased anger and irritability. This can be especially true for adolescents and children.  

Losing Interest 
When someone is suffering from depression you may notice a lack of interest in past times he or she typically enjoys. “People suffering from clinical depression lose interest in favorite hobbies, friends, work — even food. It’s as if the brain’s pleasure circuits shut down or short out.” 

Appetite Changes
Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York cautions that a loss of appetite can be a sign of depression or even a sign of relapse back into depression. Dr. Kennedy also points out that others have trouble with overeating when they are depressed. 

Low Self-Esteem 

Depression often leaves people feeling down about themselves. Depression can lead to feelings of self-doubt and a negative attitude.  

What to do
If you suspect you or someone you love may be suffering from depression talk about it, encourage him or her to get professional help and once he or she does be supportive. Remember that at times symptoms of depression need to be treated just like any other medical condition.

Originally published on http://utvalleywellness.com/

 

Couples Counseling (near Cottonwood Heights, Sandy, Holladay)

“Couples counseling” isn’t a four letter word. Knowing when to get help is important and something that every couple needs be aware of. Here are a few signs that you might need help.

  • Failed attempts to fix your marriage – many couples have/will have an experience where they need help in their marriage. They try and try and nothing gets better. They talk with friends, family and read books. They listen to online video’s from experts, but just can’t seem to get it right.
  • Significant stress in your relationship during transitional periods – couples often experience stress during transitions. Children being born, children moving out, retirement, loss of a job – or getting new job, a change in health, a move to a new city, etc… These all bring stress (even positive stress is still stressful!).
  • 4 Horsemen of the Apocalypse – Researcher John Gottman found that if you have any of the following in your relationship, that it could be in trouble: Defensiveness, Criticism, Contempt or Stonewalling. See his book, Seven Principles for Making Marriage Work.

A competent couples counselor will help you work through any of these types of issues. Couples come in to therapy years after it would be good to start. Don’t wait until its too late – most couples do.

An Ethic to Live: Building Barriers to Suicide Around Ourselves & Those We Love by Laura Skaggs-Dulin

In cities throughout the world, notable high buildings and bridges increasingly have additional fencing built atop of them with the specific purpose of preventing suicides. Suicide fences tend to work because research has shown that suicidal actions are frequently impulsive, hence such fences serve to forestall that impulse and buy individuals precious time to further think about their decisions. In studies of suicide fences, it appears that individuals don’t leave such barriers to go look for another bridge or tall building to end their lives from, but instead return to the business of living for yet another day.  

Presently suicide is the leading cause of death among young people ages 10-17 here in Utah, and over the last decade, it’s also doubled amongst adults in our state. As concerned friends, neighbors and parents, how do we help our community build more barriers to suicide; protecting and empowering those we love? Over the next year, I’ll be writing a series of articles in answer to this question; offering my perspective as both a therapist, who has stood on sacred ground in helping others walk back from suicidal thinking, and as one who’s felt and ultimately rejected the dark pull to end my life amidst heavy times.   

Perhaps you’ve already noted that there’s no way to build suicide fences everywhere or to somehow block all of the endless ways in which someone might consider ending their life. Sound public policies on prevention and physical barriers like suicide fences are only some of the important ways to help. So in addition to these forms of prevention, the focus of my writing will be on how to build barriers to suicide directly into the thinking and values of individuals, and into the culture of our community as a whole. In this first article, I want to introduce how we help foster an ethic to live within ourselves and in others as a key barrier to suicide.  

An ethic to live means valuing our lives and holding a commitment within ourselves to continue living — even when we’re unsure of how we’ll cope or move forward. In my experience, helpful conversations about consciously building an ethic to live, begin by first taking care to turn our attention to the reality that to live is to be vulnerable to an array of difficult life experiences, with the potential to evoke within us the thought to end one’s life to escape them. Throughout human history, individuals and peoples have had to confront extremely painful and unjust challenges which have overwhelmed their sense of being able to continue on, and it’s important to acknowledge that when we confront such considerable pain, it is the most human thing in the world to want relief from it. This is real; excruciating human suffering beyond one’s current sense of how to reduce or stop it is real, and in these concentrations of pain, we may find ourselves having suicidal thoughts.  

When we acknowledge and honor that such excruciating life experiences do show up for many of us, it’s then that we can locate where we need to begin building internal fences to prevent suicide. It’s here that we recognize the need to develop a strong ethic to live even though there are times that we might not yet fully know how we’ll cope or be able to see brighter ways forward. It’s also here that we find the need to define as individuals what makes life worth living with specificity to our own life experiences, as well as the need to find a listener who we can turn to and voice what’s going on inside of us. 

As you navigate life’s difficulties, no matter how hard things may get, make the commitment now to live and identify your personal reasons to do so. Additionally, identify suicidal thoughts as a  sign to find a listener who you feel safe enough to talk to. It’s worth thinking about right now who it is you might feel comfortable turning to during your hardest times. By doing so, you’ll begin to build your own internal fence between you and suicide as well as have greater insight as to how to help others you care about to do the same.  

 * If you or someone you care about is currently having thoughts of ending their life, caring help is available 24/7 by texting 741741 from anywhere in the USA or you can call 1-800-273-8255 to speak directly with a Counselor from the National Suicide Prevention Lifeline. 

About the Author: Laura Skaggs-Dulin holds a master’s degree in Marriage and Family Therapy from San Diego State University. She currently sees clients at the Spanish Fork Center for Couples and Families and at Encircle LGBT Youth and Family Resource Center in Provo

Why Should Couples Consistently Set New Year’s Resolutions Together? By Dr. Matt Eschler, Ph.D, LMFT

I have counseled couples for twenty-five years. Panicking, anxiously pacing, wringing hands, couples have wandered into my office, hoping to find some peace in their relationships. In the counseling arena we explore some very principled foundation ingredients that, when mixed together, produce peaceful, passionate relationships.

There are three fundamental ingredients that all of us need to exercise for a shot at a sound relationship. My challenge to you is to sit with your lover and assess the following three principles, and set specific goals to learn a little more, stand a little more firm, and increase your skills in these three areas:

The first foundation principle is friendship. Friendship is unilateral. Increase your friendship with your lover every couple of hours. You do this by sharing information, being trustworthy, and being transparent—without conditions.

The second principle that relationships will not survive without is influence. You must accept your lover’s influence. Men seem to have a slightly more difficult time with this, but both partners will benefit from allowing influence. Think about a time when there was disagreement in direction of relationship or activity. Did you allow your lover to have influence? Did you argue until one of you gave in? Was their healthy negotiation until a mutually satisfying result occurred? The hope is always influence and no competition. Get a little better at this in 2018!

Finally, the third principle is generating a governing purpose for your marriage. This is the North Star that holds you both accountable to a result that is desirable and cherished. If you are seeking the same purpose, you won’t go after hostile results. For example, my wife and I want to travel the world. If I sneak out and spend our travel money on a new truck and lots of clothes, we won’t have resources available to travel. That causes issues. If I save and we put our travel fund together and watch it grow together, we will eventually accomplish our common goal.

I invite you all to accept this challenge: In 2018 be a little bit better in all three of these areas. Sit with your lover and map out a specific strategy to accomplish these three goals to improve your relationship.

 

About the Author: Matt lives in St. George, Utah where he and his wife Chris are enjoying their life with each other. Since their kids have grown and moved out perusing their dreams Matt and Chris travel the world. They want to visit 200 countries before the are done. Matt and Chris are active in their community and enjoy working out, training for marathons, and spending time participating in numerous activities with their adult children.  Matt has received his PhD in Psychology. He is focused on the arena of resolving personal conflicts and improving interpersonal relationships. In addition to his Doctorate Degree Matt has earned a Masters in Marriage and Family Therapy, studied Criminal Justice and received a category I licensure with Peace Officer Standard of Training along with a degree in the Arts of Business Management. Matt is a professor at Dixie State University and hopes to be part of the positive growth of Southern Utah.

Maintaining A Relationship That Is Juicy, Fun, Passionate and Loving by Dr. Matt Eschler, Ph.D

I am pretty certain that we all hope for a juicy, fun, passionate, loving relationship with our lovers! The relationships that maintains a spark over decades of being together are built carefully they most definitely are NOT accidents! You don’t connect with a “soul mate” and settle into mandatory bliss. If you are hoping, longing, reaching for a juicy fun passionate relationship then you will want to read the rest if this article!

Juicy fun passionate relationships are created. If you keep a few rules you can be certain your marriage is all you ever fantasized about! Keep these three incredibly simple rules of engagement and juicy, fun, passion will be yours!

Get to know each other every day.

By constantly developing connection and strengthening your relationship bond you breath new life into your marriage every chance you get. Sometimes you will be giving rescue breathes during crisis and struggle while other times you are giving extra oxygen creating a sense of peace and relaxation. Know your lovers top five or six needs to be happy. Many couples think they know each other and know what drives happiness only to find they have lost touch with change, growth, and each other. To keep on the razor edge front line of juicy passionate fun you have to meet together and talk. I suggest three meeting a week is the minimum. These three meetings each come with there distinct purpose. First have a date night. This is where couples flirt, tease, kiss, and talk about hopes and dreams with each other. Second meeting is couples council. In this meeting you discover the struggles you each face. You empathize with each other, grow through strife and strain while talking about hard topics trusting you will stand by each other for better or worse. Third meeting is family night. This is a time to organize your family share family activities, dreams, and structure the household as a unified front. All three of these meetings are really mandatory and refreshing if you engage weekly on purpose.

Transparency

Second of the three “must” for juicy fun passionate relationships is all about transparency. Share your whole self holding nothing back. If you only share what your lover approves of your holding them hostage. Allow your lover to see all of you and realize your love for each other grows with knowledge of what makes us tic. Sharing a deep sense of fondness and adorationfor each other! (Number one cause of divorce is contempt) is a major part of the intimacy you will Experience. Have you ever caught yourself thinking fond thoughts about your lover and not expressing these thoughts out loud because it feels way vulnerable? My challenge to you is be vulnerable every day! Dare to share all your fondness and admiration out loud and often! Pray with each other express gratitude to the God of your understanding for each other. Imagine the power you will have as Couple joining in prayer to begin each day unified! Celebrate victories, Support each other’s interests, and helping achieve each other’s dreams are all ways of generating juicy fun passionate marriages. I think you get the idea.

Positive Sentiment Override (Gottman Term)

Finally the third principle followed by juicy, passionate, fun couples is a constant positive sentiment override. You always have two choices in how you SEE your lover. You can think negative or you can see the good. You can interpret what is said through a filter of offense. Seeking to be offended will generally lead to you finding a way to actually be offended. The thousands of interactions will be filled with minor slights and errors that can be exploited and used to feel sad, hurt and bugged a each other. On the other hand you have every right to filter all those same interactions through a sieve that separates out all the warm juicy passionate sentiments and feel love and joy. It’s really fun p to you! No, your not burying your head in the sand your simply seeking the good gifts offered.

Think about all of this and have an incredible juicy fun valentines month in February.

About the Author:  Dr. Matt Eschler lives in St. George, Utah where he and his wife Chris are enjoying their life with each other. Since their kids have grown and moved out perusing their dreams Matt and Chris travel the world. They want to visit 200 countries before the are done. Matt and Chris are active in their community and enjoy working out, training for marathons, and spending time participating in numerous activities with their adult children.  Matt has received his PhD in Psychology. He is focused on the arena of resolving personal conflicts and improving interpersonal relationships. In addition to his Doctorate Degree Matt has earned a Masters in Marriage and Family Therapy, studied Criminal Justice and received a category I licensure with Peace Officer Standard of Training along with a degree in the Arts of Business Management. Matt is a professor at Dixie State University and hopes to be part of the positive growth of Southern Utah.

Hidden Signs of Depression by Alberto Souza, MSN, APRN, FNP-C

Studies show about 1 out of every 6 adults will have depression at some time in their life. This means that you probably know someone who is depressed or may become depressed at some point. We often think of a depressed person as someone who is sad or melancholy. However, there are other signs of depression that can be a little more difficult to detect.

 

Trouble Sleeping

If you notice a change in a loved one’s sleeping habits pay close attention as this could be a sign of depression. Oftentimes depression leads to trouble sleeping and lack of sleep can also lead to depression.

Quick to Anger
When a person is depressed even everyday challenges can seem more difficult or even impossible to manage which often leads to increased anger and irritability. This can be especially true for adolescents and children.


Losing Interest
When someone is suffering from depression you may notice a lack of interest in past times he or she typically enjoys. “People suffering from clinical depression lose interest in favorite hobbies, friends, work — even food. It’s as if the brain’s pleasure circuits shut down or short out.”


Appetite Changes
Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York cautions that a loss of appetite can be a sign of depression or even a sign of relapse back into depression. Dr. Kennedy also points out that others have trouble with overeating when they are depressed.


Low Self-Esteem

Depression often leaves people feeling down about themselves. Depression can lead to feelings of self-doubt and a negative attitude.

 

What to do
If you suspect you or someone you love may be suffering from depression talk about it, encourage him or her to get professional help and once he or she does be supportive. Remember that at times symptoms of depression need to be treated just like any other medical condition.

Sources

Healthtalk.org

helpguide.org

Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.