Excerpt from "Self Help for Managing the Symptoms of BPD"


Before we launch into the diagnostic criteria, I would like to explain the concept of splitting to you. Once you understand the role of splitting in your illness, you can really make some headway towards your healing. Splitting, simply put, is thinking in terms of black and white, or all or nothing.

Since we’ve lived with this thinking most of our lives, we accept is as just a part of our personality. In fact, it is part of our illness and responsible for much of our misery.

Some expected outcomes of this type of thinking are intense emotional responses and blaming loved ones for things they have not done.

This type of thinking is integral to almost all of our other symptoms, and working on changing this way of thinking will surely increase our quality of life dramatically.

Learning that life is not either/or, it is both/and, will greatly improve your life experiences. You will learn to become aware of each thought and to retrain your brain to think differently than you have in the past.

How does one even begin to recognize their own thoughts and change the way they think?

In my personal experience, Dialectical Behavioral Therapy, or DBT (see back of booklet for more information) is the most effective way to retrain our brains to not think this way. If you do not have a DBT center or therapist near you who will teach these skills, a therapist who genuinely understands the way someone with BPD thinks and who will actively utilize Cognitive Behavioral Therapy, or CBT, is another good choice.

There are other means to augment what you learn in DBT (or CBT), including yoga, meditation, and support groups which emphasis changing your distorted ways of thinking.

Now we will launch into the diagnostic criteria and ways to manage each symptom! I will begin each with the clinical definition, straight from the DSM-IV manual, and then add my own helpful tips.

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Criterion One

As quoted from the DSM IV, this criterion indicates “frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

Individuals with Borderline Personality Disorder make frantic efforts to avoid real or imagined abandonment. The perception of impending separation or rejection, or the loss of external structure, can lead to profound changes in self-image, affect, cognition, and behavior. These individuals are very sensitive to environmental circumstances. They experience intense abandonment fears and inappropriate anger even when faced with a realistic time-limited separation or when there are unavoidable changes in plans (e.g. sudden despair in reaction to a clinician’s announcing the end of the hour; panic or fury when someone important to them is just a few minutes late or must cancel an appointment).

They may believe that this "abandonment" implies they are "bad." These abandonment fears are related to an intolerance of being alone and a need to have other people with them. Their frantic efforts to avoid abandonment may include impulsive actions such as self-mutilating or suicidal behaviors, which are described separately in Criterion 5.”

Managing the Symptoms of Fears
of Abandonment

1. Understand and validate that your fears are real to you but may not be shared by others. Accept that those
without BPD may not understand your fears because they do not share them.

2. Use the logical side of your thinking to reassure yourself that your loved one’s absence may not mean what it feels like to you.

3. Calm yourself by thinking both of your loved one’s needs and feelings in addition to your own. Perhaps they are trying to make money or just take care of themselves AND care about you at the same time.

4. Prepare yourself for separations. Assemble photographs or an object of clothing of your loved one. As you look at or touch these objects, think of happy times together and the love you’ve shared.

5. Explain your impending anxiety and then ask for specific times of when they are leaving and when they will be returning to help with feelings of uncertainty.

6. Think through what you will do during times when you are apart. Make a list of indulgent activities you enjoy and engage in them liberally. Be good to yourself during these stressful times.

7. Have a list of people you can e-mail/text/call or chat with in order to connect with others.

8. Look at the journal of good things about you listed on page thirty-three.


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