An overview of Valerie Porr’s Book Overcoming Borderline Personality Disorder: A Family Guide for Healing and Change (2010).*
Families must try new strategies especially when their loved one refuses to get help. Be assured that I do not want to blame parents for causing the problem. Parents have been blamed for far too many years. However parents can change their attitudes and improve their communication skills which will help their adult child. When parents use validation the emotionality of a person with borderline will decrease. This strategy will help those with ill spouses and/or ill parents too.
Validation is mentioned in Marsha Linehan’s Skills Training Manual for Treating Borderline Personality Disorder (BPD). To understand validation we need to understand the biosocial theory of BPD. The Main tenet of Linehan’s biosocial theory is that “the core disorder in BPD is emotional dysregulation. In other words people with BPD have difficulties regulating several, if not all, their emotions.” There is a biological component and an environmental component. She posits that their problems occur because of an emotional vulnerability of the child and maladaptive or inadequate responses from their environment to emotion modulation strategies. She suggests that a child can have problems either because parents are unable to sooth their children due to the child’s over emotionality and /or the over emotionality of the child creates an environment that causes the parents to react in invalidating ways. For example it could be that the behaviour of the child is overly intense and parents react in strong ways –ignoring, telling the child they are over dramatic, shouting, hitting or disciplining. None of these ways validate a child’s feelings; in fact they are the opposite. Any time that you deny what the person is feeling they are not being validated. People who suffer due to Borderline feel emotions as intensely as they display their distress. They are not faking and they can’t stop it. But with treatment they can learn ways to feel in control. You need to understand that they believe their reality even if, to you, it is not logical. If you can acknowledge their suffering and, acknowledge that the distortions of reality are troubling to them then their stress will go down; they will feel that someone finally understands. If you decide that they should be acting differently –”more normally” -you are not validating them and the person will feel criticized. This affects their self esteem. I encourage you to look at your loved one in a different way which will help you to change your approach and you will have more positive interactions with them.
Valerie Porr states that “The first crucial step toward family relationship repair is accepting that the person is doing the best she or he can, right now, at this very moment”. “Perhaps you believe she is manipulating you (or she is extremely willful), or that she could do better if only she would try harder and apply herself”. Porr asks, “Why would anyone want to be financially dependent on others, live on social security or welfare, continuously lose jobs or relationships, or spend so much time in the emergency room? Accepting this idea will help you to decrease your judgmental attitude and will help foster acceptance of the person as they are in the moment.” A person with BPD wants to improve but s/he lacks the skills to do what others take for granted. People with BPD are also encouraged to live in the moment. “They may not have caused all their problems but they have to solve them anyway.” This is called radical acceptance. The focus moves away from blaming and toward effective problem solving. Part of acceptance involves being aware that your person is suffering.
An important thing to remember is that trying to solve problems for your loved one does not work. This makes the person feel less competent and creates dependency. “The person needs coaching and help to develop a sense of his own accomplishment. The family member must believe that their loved one has the capacity to get through his emotional hell. The family member needs to tolerate their own distress and give their loved one the opportunity to master life skills.”
Do not take the abusive words so personally. Most loved ones do care about you but get very upset and cannot control everything that comes out of their mouths; which is why they apologize or change and act differently later. Also “Family members must accept responsibility for their past insensitivity to their loved one’s pain and develop compassion for her present pain”. Family member must have a relationship of equals(Porr) or as Helene Busque creator of our Borderline Training Course suggests the relationship must be based on respect and must be one from adult to adult. A person with BPD often feels out of control and if you do anything to help, it looks like you are taking control. Even if it seems that control is needed; if you act you are taking away the person’s opportunity to learn. The family needs to let go and allow the loved one to experience the consequences of his or her own decisions and choices (Porr).
Validation(according to Porr) requires that you reflect back to what the other person is feeling, even if you do not feel the same way or do not agree with what s/he is feeling. Validation involves sympathy, compassion and empathy. Sympathy “is being sensitive to the feelings of another. It is not pity but it can be misunderstood by borderlines and it is not validation”. Compassion is “a deep awareness and understanding of the suffering of another”. “Hope enables us to overcome despair. Compassion develops courage to overcome fear… therefore your tendency to be selfish will decrease.” “Doubt, or suspicion interfere with the cultivation of compassion as it requires faith”. The more you learn about the difficulties of your loved one the easier it will be to cultivate compassion. Empathy “is the ability to put yourself in another’s person’s place and to feel vicariously the other person’s feelings as if you were that person”.
Validation involves unconditional acceptance: now, no judgment, as they are,- giving up controlling the other nor imposing your values or views. Porr says that to communicate unconditional acceptance, you need to make an active effort to listen and observe what is said and how it is said, felt or done in a nonjudgmental manner so that you can understand what is actually being said and be able to unconditionally validate the person. People with BPP need to feel unconditional acceptance; love is not enough. Porr asks that we accommodate them like you would if the person needed a wheel chair or you would cook differently if they had allergies.
People with BPD interpret families’ efforts as punishments or control. There is a grain of truth when families ask their person to do something they are not capable of –for instance controlling their emotions when they do not have the skills.
Putting validation into action: Paying attention means that you observe the intent of the communication, not agreeing, not criticizing or judging. During this phase you describe what you see. The facts are stated not interpreted. You can notice a thought, “I can see that you thought that he had betrayed you”. Describing is not about you, it is about them what they feel and interpret-it shows them you are paying attention. Accurate Reflection is like a mirror, again without judgment. Reflection helps them feel heard. You can identify their thoughts and assumptions and emotional responses. Use simple language. Reflecting their feelings legitimizes what they are feeling. “I can only imagine how embarrassed you felt”. Or “I sense you are really very angry about this.” You must use a tone of warmth and acceptance for the person to feel understood. “To reflect accurately you need to look at what happened and at your loved one’s response from her perspective, regardless of what you personally think about the situation, why it happened, or how she responded”. Linehan says there is always a nugget of truth.
For intuitive understanding you must imagine how you would react if you were supersensitive, hyper vigilant and biased toward negative thinking. All of the problems surface in situations of stress. Would you make good decisions if you had these problems? “Research demonstrates that people with BPD are shame and rejection prone, so you can usually count on shame as the most common emotional response”. Your job is to try and imagine what feelings led up to the shame-was it incompetence, fright anxiety or loss. At first this may be difficult. They are not you. As you get better at understanding these thoughts and feelings and you express them you will be validating your person. And they will feel more secure. If you guess wrong keep listening and you will learn. “In order to help your person you just be able to see the world through his eyes, and radically accept that his reality is different from yours”.
Validation of the past can help a person to accept how and why something happened. Blaming present problems on past events prevents a person from taking action in the present and moving forward. Porr suggests validating past experiences by acknowledging past pain in the context of the present, will help your loved one let go of the past pain and move on to begin to live in the present. Focusing on the way the world “should be” or “should not be” is a way to distort reality. Your loved one needs to see that neither wishing nor denying reality can change reality.
Validating memories: When people with BPD experience a pain, they feel other painful moments of their lives like they were living them today. And then they replay them like a loop. When this loop of pain starts you may defend yourself or debate right and wrong with them but all of this will fuel the emotional fire. Porr suggests you try not to correct facts or the logic of the member- instead validate the emotions of the memory whether you agree or not. If your person says “You were never there for me”. You could reply, “It must be awful to feel that I never was there for you. But that was then and this is now. What are we going to do right now.”
We make mistakes and it is good to acknowledge them. No one is perfect and we all feel shame, humiliation, or guilt. We apologize and move on. We acknowledge their negative emotions and accept them. We all have dark or negative emotions or thoughts from time to time. We just don’t act on them. I encourage you to focus on how hard they are trying to cope or control their behaviour. Try to focus on the positive aspects of your loved one’s behaviour and learn to find the nugget of truth.
*Please read the entire book if you have a loved one with BPD. There is a description of the BPD neurological problems, validation, Dialectical behaviour therapy and mentalization.