TW: Discussions of BPD, mental health, suicide.
Following on from my last blog, I wanted to talk more in-depth about problem solving and overcoming an episode. I apologise but this is a long read. We’ve identified what can trigger an episode, but how do we get over an episode with minimal collateral damage and in a healthy way?
Just because you’ve had therapy or are on the best medications, doesn’t mean an episode can’t happen. Having this perception of perfection is incredibly dangerous because you hold yourself to an unrealistic ideal, which causes you to beat yourself up when you have a bad day. Not only does this cause an inner battle with yourself, but it makes you fearful to let people in, because you’re so afraid you’ll make a mistake and lose them. We know this fear is a product of the fear of abandonment. Mistakes happen, its inevitable. It doesn’t mean you’re not recovered it just means you’re in a situation which caused you stress.
The key difference between being recovered and not, is what you choose to do during an episode. If you allow your emotions to take over, use unhealthy coping mechanisms and hurt people because you can’t reign yourself in, you are not recovered. That’s not to say you can’t recover, it just means you should seek help, and there’s nothing wrong with that. When you’re recovered, in a stressful situation, you use healthy coping mechanisms, take time out for you, and logically come up with a solution. Now I know what you’re thinking, ‘how do I possibly get through stress when all I want to do is hide in my bed and cry?’. It’s simple really.
1. Get Calm
When you have BPD, calm is not part of your vocabulary. Emotions are intense; if a ‘normal’ person is happy, we feel ecstatic, if a normal person feels sad, we feel suicidal. When I explain my extreme moods, people find it hard to understand, as it’s not something they experience. It’s common that people with BPD get called a ‘drama queen’ by people who aren’t aware of their diagnosis (I would know). But whilst communicating with loved ones, break it down as much as possible, give examples and don’t feel disheartened if they don’t understand, if they’re respectful and are there for you in a healthy non-co-dependent way, you’re golden.
I digress, but there are two techniques I use for calming: box breaths and grounding. Imagine, you’re at work, suddenly an external influence feels like a bomb has dropped in your stomach. You feel tears form, you can feel your heart flutter and you begin to dissociate. Stop. If it was a text, stop looking at it. Take away whatever triggered an episode. If you’re with people and you’re able to leave, calmly say you need a minute. But if you were like me last week, sitting in a court room in front of a judge, you can’t leave. So, breathe.
Take four seconds to breathe in, hold it for four seconds and let it out for four. Keep repeating this until you feel yourself getting calmer, do not hyperventilate, take it slow. Fun fact for you, box breaths are used in army training to calm soldiers in stressful situations, because it scientifically stops anxiety. If you can, elongate your breath and do that exercise for six seconds, or eight, the quicker you will feel yourself calming down. I recommend trying to visualise something which makes you feel happy or a moment of positive emotion which you would like to transfer to. I sat an exam over September and before I started my paper, I imagined myself sitting in my high school sports hall before my last A-Level, focusing on the excitement and confidence I felt at the time.
Your second option is to ground yourself, typically this is the ‘five-thing technique’, where you name five things you see, smell, hear etc. A simpler way to do this, which I’ve found more successful, is to ‘mindfully’ do something. What I mean by this, is find something physical to do and really focus on the action. Let’s use typing as an example. How do the keys feel on your fingers? What sound are they making? Do your nails make any sounds? When you have BPD, you tend to hyper focus on the stress, so redirect this fixation on what you’re doing to ground yourself back in the moment and calm. Honestly, I do both but play around and see what works for you.
2. Assess the thought and situation.
If you’re not calm, do not do this. You will probably act emotionally, irrationally, and maybe even recklessly. However, if you feel as though your emotions have subsided, it’s time to assess what’s going on.
You can take some time out. Don’t feel like as soon as you’ve finished breathing in for eight seconds you have to go straight to the problem. If you want to go do something fun and distracting, go for it! Sometimes it’s better to go on a walk, watch a film and completely indulge in something that makes you feel good so you can reaffirm good feelings. Sometimes when I’ve calmed myself down, I may not be fully ready to think about it, so I have a hot bath and binge watch a series. When ready, let’s assess.
What has just happened? I’ve received an upsetting text message. How do I feel? Worried, anxious and incredibly confused? Do the facts match these emotions? Here, assess what the text said, who it was from, is it likely that this was supposed to upset you or are you reading into it? If the answer is ‘no, my emotions don’t match with the facts I just freaked out and started thinking in extremes’, then you can simply let go. Affirm to yourself that you’re okay, affirm the facts to yourself, recognise that it’s a symptom of BPD. The more honest you can be during an episode the better you will get at overcoming your natural responses. Counter those thoughts!
3. Find a solution
If your emotions match the facts, and you felt sad because you’ve received bad news, or angry because you’ve gotten into an argument, then it’s time to problem solve. If you’re upset due to a conversation, explain what’s happened and how you’re feeling to others involved. Remember not to get accusatory and say things like ‘you made me feel like this’, ‘you should do this’, because that will lead to further conflict. Instead, use the ‘DEAR MAN’ principle; describe, express, assert, reinforce, mindful, appear confident and negotiate. Let’s break down ‘DEAR’ which helps with the communication itself.
Describe what’s going on using facts and facts only, say ‘I got that text message from you’, to start. Express how that made you feel using ‘I”, never use ‘you’. Saying things like ‘I felt incredibly confused and overwhelmed’ or ‘I felt upset’, focuses the conversation on you at first and is non-accusatory. Assert yourself next and come up with possible solutions to the issue at hand. Always remember to continue using I, like ‘I would like it if…’ or ‘I think we could try…’. In my specific example, I’d say ‘I would like it if you could explain your concerns clearer’. Remember you’re only suggesting solutions, not demanding them. Lastly, reinforce what’s being said, if you’re having a good productive conversation, say ‘thank you for being understanding’. Always openly communicate and positively reinforce the conversation so it stays productive.
Once you have communication down it’s time to goal set and act, this is where ‘MAN’ comes in. Be mindful of your goal. When you have BPD, it is incredibly difficult to stay on track during a conversation, because if things start to heat up, your emotions begin to take over and things get messy. Keep saying your points repeatedly if you feel an argument coming on so you don’t lose sight and become emotional. If it gets too heated, walk away until you’ve both calmed down. Saying things like ‘I would really like to talk about …’ or ‘I would like to resolve…’ will help. Appear confident! This is all about delivery and how you talk to someone. Keep eye contact, keep still, and remain calm. Don’t get cocky and bullish, this creates tension. Also, remember not to become vulnerable and passive and agree to everything being said because you’re afraid of confrontation. Finally, negotiate how to overcome an issue. Talk together and make it a team effort. Listen to responses and take them into account at the same level of importance as your own. For example, if the reason behind lack of communication is the time commitment it takes because of schedules, then tweak your goal. Instead of asking for immediate clarification, perhaps ask if serious conversations, which help the growth of a relationship, can happen when it’s convenient for both of you to avoid any anxiety and confusion in future. I’d like to note, that it’s incredibly hard to negotiate when you have BPD due to splitting. But remember there are multiple answers to one question and nuances. Just because you might not get your original solution, it doesn’t mean the problem hasn’t been sorted or that person doesn’t care.
I really hope this helps and gives a clearer structure on how to problem solve and stop the intensity of an episode. Until next time.
---- Tasha Hardaker, President
