Overcoming Borderline Personality Disorder by Valerie Porr

[positivenergy]

I recommend that anyone who cares about a person with BPD buy a new book called "Overcoming Borderline Personality Disorder" by Valerie Porr.

Here's what John Oldham, Chief of Staff of the Menninger Clinic says about this book: "Overcoming Borderline Personality  Disorder by Valerie Porr is like water for a parched land. Few psychiatric disorders are as misunderstood as BPD, a condition that can be  profoundly disabling to patients and devastating to families. Opinions about what families should do are plentiful- but evidence based guidance, derived from solid research, is rare. This is what this book delivers. It is an invaluable roadmap for families of patients with BPD."

This book is the antidote for all of the misinformation, bad advice and tough love literature you'll find in books, the web and in the offices of mental health professionals. Valerie Porr writes in a clear, concise manner and never talks down to the reader. By describing what is happening in the brains of people with BPD, Porr helps the reader to understand that the illness has a biological basis. Ms. Porr then shows how this neurological disorder causes the person with BPD to suffer and explains why they act in ways that SEEM to be manipulative and despicable, but are actually reactions to their own personal suffering.

Finally, and most importantly, Ms. Porr offers the reader a plan to help the person they love to change. This is a book about being compassionate and effective. If you follow its prescriptions, it will not only help you change the life of someone you know who is suffering from a terrible illness, it will change your life too.

[bpdfamfan]

Thanks for the book suggestion.  I think this will be my next purchase!
If you get a minute please copy & paste your review onto the book review section too.   

[Maytree]

I am currently working my way through this book, "Overcoming Borderline Personality Disorder: A Family Guide for Healing and Change" by Valerie Porr. I am currently on page 144, in the section "Understanding and Applying Validation". 

I am having...issues...with this book. I was wondering if anyone else had any issues with it as well (and if I should perhaps be posting over in book reviews instead of, or in addition to, here?)

First off, let me preface by saying I am not saying this book is necessarily worthless. For one thing, I'm not done with it yet. For a second thing, I think there is a lot of value in here for parents dealing with a BP child, and possibly also for someone who had had children with a BP partner and is attempting to improve relationships with the BP in order to spare the children as much distress as possible (which I wholeheartedly support.)

However, I think this book might be actively damaging to non-BP children of BP parents.  I won't get into specific criticisms right here because it would take too long (and I don't know if anyone else has this book, or has read this book, so saying, "On page blah she says this, and my objection is such-and-such..." would be pointless) but I will try to state the general gist of my dissatisfaction.

Here's the analogy that I'm considering. Say you are swimming at the ocean beach and you hear a scream for help from out in the ocean.  You look out across the water and see someone struggling, possibly drowning. They look utterly panicked. Maybe they are stuck in a riptide; maybe they just got in over their head and swallowed water; you can't tell from where you are. But they seem to be in significant trouble, possibly in danger of their life.

Do you dive in after them to rescue them?

Generally, no. Unless you are a trained lifeguard in good physical shape with equipment handy (such as a flotation device.)

Why not?

Because you probably aren't trained in rescue procedures. You may not be a strong swimmer yourself. And a person who is drowning, or thinks they are, and who is panicking stands a very good chance of dragging you down with them. This is a critical point. By going in after them without training, without the needed physical strength and swimming skill, without the appropriate equipment, you most likely will not only fail to save them but you will drown yourself. You will be caught in the riptide and pulled under. Or the person himself will seize you around the neck, trying to save themselves, and you will be unable to swim. You will swallow water. You will go down. And you will both die.

Trained lifeguards know that sometimes if a drowning person is panicking, it is necessary to SLUG them, stun them or knock them out, to get them to go limp and stop impeding the lifeguard's attempts to get them to safety. Then, and only then, can the lifeguard get a jacket on them or a ring around them and tow them into shore. Only then will both the drowning victim and the lifeguard as well be safe.

In this book, the person with BP is repeatedly referred to in terms that make them analogous to the drowning person. They are in waters over their head. They cannot swim. They did not get there intentionally, but they have no idea how to get out. They may not have the strength to swim against the riptide; they may not even know a basic Dead Man's float to keep their head above water even if there is no riptide. And they are so panicky that they will impede any well-meaning attempt to get them out of the water. They cannot help their would-be rescuers be effective; all they can do is succeed in endangering the would-be rescuer.

This book appears to go out of its way to encourage all people who love their BP person to jump right into that ocean after the BP, heedless of their own safety, without doing any kind of self-check to make sure they have the training, and strength, and skill, and equipment to make a real rescue attempt with a possibility of success and a reduced chance of killing the lifeguard. People who have BPs in their lives are encouraged to offer them whatever they need to try and get out of the drowning ocean -- endless compassion, endless validation, endless energy, endless attention. The BPs NEED these things, the book argues, or they will invariably drown.

But what if you need that compassion for yourself? You need validation for yourself? You need energy for yourself, for your spouse, for your own children (in the case of we non children of BP parents)? You need the energy for your job, your livelihood?  You need to pay some attention to things in your life other than the BP?

What then?

This book pays a certain amount of lip service to the "difficulties" (vast understatement) of having a BP in your life. But it reserves the huge bulk of its caring and concern for the BP who said to be carrying the "stone of pain" or "wearing the TARA tiara" (of neurobiological dysfuntion). There is a unspoken but unmistakable sense that the authors believe that nons who disengage from their BPs, who say "I can't do this anymore, I am drowning, she is taking me down with her and I WANT TO LIVE", are lacking in compassion, or insufficiently motivated to "help" their BPs.  The BPs are not responsible, says the book. They are confused, angry, living in an emotional world they can't make sense of, that always seems to be attacking them, with people who never seem to be able to give enough to them to fill the void in their souls, who can never make them feel truly safe and loved. And this book seems to think that we nons are responsible for dealing with this because the BP is incapable. We should put up with being demonized because the BP can't help it. We should always be compassionate, practice radical acceptance, always validate the BP's feeling no matter how completely out of touch with genuine reality those feelings are. The BP can't help feeling that way. Their mind is attacking them, forcing them into feeling this way. Never leave the BP, because the BP is sick, needs our help, and might die without it.

While I can accept that many BPs are in fact truly NOT "morally responsible" for their behavior, I find this book's attitude toward complete acceptance of that behavior to be quite frustrating and invalidating toward nons.  This book explicitly states that one should not "set limits or boundaries" with BPs because...well, because it makes them feel bad. It makes them feel more pain. And that makes them act out more and behave more badly toward themselves and others. (A minor but important digression here: The thing that really puzzles me about this book is, although it repeatedly denigrates the notion of setting limits and boundaries with BPs, many of the examples it has given so far of effective therapeutic techniques show people doing exactly that! For example, it gives the example of a self-harming teenager who self-harms then calls her mother for a ride to the ER. The book suggests that the mother tell the daughter to find her own way to the ER, and find her own way home again. This sounds to me like definite limit and boundary setting, yet the book repeatedly says that is not a good thing to do with BPs. The inconsistency is puzzling, to put it mildly.)

So that is the heart of my dilemma with this book. It assumes we nons are all equipped to be lifeguards. And we are not.

Is it really the responsibility for nons to become lifeguards for the BPs in their lives? Certainly there is no harm in learning some lifeguarding skills, in gaining better strength and skill in swimming -- IF you have the capability to swim yourself (I might argue that asking non children of BPs to become supports for their BP parents is like asking a quadruple amputee to become a lifeguard at a beach -- it ignores the damage done to the BP's child by the BP's disorder that very probably has rendered them unfit to ever be a lifeguard, through no fault of their own -- their limbs have been cut off!) and IF you have the time and energy and money available to take classes on lifeguarding skills and do the physical workouts necessary to develop strength and skill. But even if you undertake the training and devote the time and energy to becoming a lifeguard, you still have to keep in mind that a panicky drowning person is a danger to you as well as to himself -- and you have to know how and when to punch out the drowning person to make it possible to save them. And you also have to learn the skill to disentangle yourself from the drowning person's panicked clutch around your neck, and, if necessary...to leave them to drown if you determine that your skill and strength are not sufficient to enable a successful rescue.

That is the gist of my dissatisfaction with this book so far. I will toss out a few more analogies that occurred to me as I read, as further food for thought:

This book says that BPs engage in behavior that damages others in order to obtain short-term relief for their pain. They lack the capacity to see and understand that in the long term the behavior will cause them MORE pain as people withdraw from them and shut them out to avoid the damage. Their immediate pain is simply too great to let them see and act in their long-term best interest. So let's draw an analogy with, for example, a pyromaniac. This is a person who sets fires to express anger, or, in some cases, just because they are so attracted to the dancing flames they will start a fire anywhere just for the pleasure of watching it burn. They need that excitement so much they will start a fire regardless of whether there are children in the building they have just set on fire.

Do we hold them responsible if children die in the burning building?

Damned straight we do.

Do we say, "To keep them from lighting more fires, we must understand their need to set fires, radically accept them as they are, and love them and support them until they no longer need to set fires to feel fulfilled"?  ...Not if we have any good sense we don't. The fire bug has to have enough self-awareness to say "I know it is wrong to set fires. I know WHY it is wrong. I do NOT want to burn any more children to death to satisfy my urge to see a fire. Please lock me up or put me under house arrest until I can be sure, and you can be sure, that my compulsion will not harm anyone else. Only then should I be free."   This book seems (to me) to be encouraging nons to let the firebug BPs in their lives run rampant and set emotional fires that cause real, lasting damage, out of compassion for them and the "realization" that they "can't help it, they are sick and in great emotional pain." While I would not say we should have NO compassion for an emotional firebug who can't help himself, I think we need to have MORE compassion for the dead or horribly burned children. I think we MUST protect ourselves, our children, our spouses, and other people the BP may be hurting, from the fires the BP can't help setting. First, we put out the fires and help the survivors recover as best they can. Second, we stop the sick person from starting any more fires. THEN AND ONLY THEN do we turn our compassionate gaze on the firebug and say, We will try to help you to learn to not set fires, to not set any more fires, to be happy without fires in your life.

This books seems to want us to jump to step three, insisting that putting out the fires started by the firebug is not the priority, that taking the fires away from the firebug will just make the firebug that much more desperate to start another fire for fulfillment, that the firebug needs compassion, understanding, time, energy, and love more than the people who have lost lives and homes and been horribly and permanently burn-scarred by the fires set by the firebug.

As a second analogy I will use the example of a child who is neglected and abused at home and joins a gang for support, safety, and a place to belong. This child then becomes involved in gang activity -- and one such an activity is a drive-by shooting where three innocent people, one of them a two year old child, are shot.

Do we feel compassionate toward the gang member? Yes. Do we have an intellectual understanding of the needs that drove him to join the gang, of what benefits he gains from gang membership, of how he is trying to survive in a hostile environment using the only effective tools he sees around him for doing so? Yes.

But do we let him off the hook for the deaths or injuries of three people, one of them a child, just because of our compassion for what he has suffered and our understanding of his reasons for joining a gang?

No.  He is still responsible. People are still dead or hurt, people who, if they still live, or if they have surviving family members who are grieving, have needs that must come first, before the needs of the gang member.

A harmful BP belongs to a mental gang of which only he or she is a member, committing drive-by emotional shootings on all the people who get close. An exceptionally brave or compassionate person might seek to approach the gang member and ask him to stop shooting randomly out of the car at passers-by, but what are the chances the gang member will do so just for the asking?  And if you want to protect yourself, and the others who may be depending on you such as your children and spouse, wouldn't the smarter and better move be for you to get out of the range of the gang member's guns, if you can? Certainly you have a responsibility to protect your children and spouse from flying bullets.  It is not useful to say "The gang member has had a much more difficult life than you, he is in emotional pain, he does not know how else to express his feelings" -- when you are being SHOT AT.

So this is what I want to ask Valerie Porr, the author of this book.

1) If we feel a BP is going to drown us, are we required to risk our lives trying to save them even if we are certain we do not possess the skills,  strength, or equipment to succeed in a rescue? (And the question is even thornier for we non children of BPs -- because it is THEIR responsibility to rescue US and not the other way around.)

2) If a BP is setting emotional fires and committing emotional drive-by shootings, must we stand there and be burnt and shot until we have loved and accepted the BP enough that they stop, if they ever do? How much damage are we required to absorb in the name of love and acceptance of the BP? Is there a limit?


I would love to hear from anyone else has read or is in the process of reading this book.

-- May

[Ankakusu]

Hi Maytree,  !

I haven't read the book, and I probably won't, because based on your description, it sounds kind of like poison. And possibly written by an enabler.

The ideas you summed up reflect the mindset of the second, overtly saner tier of my momster's friends (the first tier being probably PD'd flying monkeys--people who worshipped her uncritically and did her bidding). This second tier was made up of stable-looking, upper-middle-class, financially and artistically successful couples who seemed to need momster and our feckless FOO around to feel better about themselves, and who also lived at some distance from us, or whom we generally saw less frequently. One friend of late momster's in particular said after momster's death that momster had seemed like "the unhappiest person I have ever met," and that, given momster's repeated meltdowns and rages because I grew and individuated and went off to college and stuff, couldn't I have "oh, I don't know, toned it down a bit? You saw how much she was hurting." You mean--not grown up/older, gone to college, gotten a job, etc.? "Well, yeah, at least to the best of your abilities, within reason, or...well, I don't know, something like that. Not done so...much. Given how painful it was for her."

This from a woman who denied her children nothing that would help their development, and who supported every dream they had, no matter how far-fetched! Who enables them to find themselves expensively all over the world! It's just more of this theme that permeates the statements of many enablers and/or people who would prefer to remain willfully ignorant: "Everybody deserves rights like the right to live free of oppression and to be themselves--oh, except you, because of your parental situation. Please keep your situation under control and don't bother us about it, so we can continue to say "honor thy father and thy mother" and "blood is thicker than water" and "turn the other cheek" without having to question the validity of these platitudes or what we are condemning you to by spouting them at you when you're in need." Etc.

Though it sounds like you already know this, you really don't need to do any of that stuff if it's not right for you. (Can't imagine it being really right for anybody, but I acknowledge that my past makes me biased.)

[Ann2034]

In "Understanding the Borderline mother" the author uses the drowning analogy as well. She say's something along the lines of how children need to understand that the pwBPD is in a sinking ship and that in order to survive they need to swim to shore.

I think it just comes down to your philosophy in life. My sister and I are a perfect example of that. Her fundamental philosophy is that if the pwbpd is your mother and gave you life, you owe it to her to take care of her. My belief is that I'm my own person and if she's incredibly abusive that nullifies my responsibility. Whoever wrote that book probably wrote it for people like my sister who feels the need to hold my mom above water. I'm sure that for people who choose to take responsibility for their pwbpd its a helpful book, but it ignores the trauma that we go through in taking that responsibility, so the underlying message seems really faulty to me.

[blackandwhite]

The primary audience is parents of children with BPD. The author is very active in that community and has been an effective advocate and organizer.

I found the book very helpful in explaining the brain science. The guidelines for relationships are probably not going to be as helpful for those with a parent with BPD and may be extremely troubling, as Maytree describes. I wouldn't necessarily recommend it if it would be difficult for a reader to screen out what doesn't apply, or if you're not pretty far along in your process of recovery (such as the very late steps of the Survivors' Guide).

In the spirit of looking at ourselves, understanding ourselves, and taking care of ourselves, it's good to recognize others are in a different place sometimes, and step away without rancor.

I'll merge this discussion with the book review.

B&W

[Maytree]

Thanks for reading my post, Ankakusu. It got longer than I intended. It seems this book is stirring up a lot of powerful emotions in me. I'm very glad I read "Stop Walking on Eggshells", "Surviving the Borderline Parent", and "Toxic Parents" BEFORE I found this book, because the validation in those books was very important. I do intend to finish this book -- for one thing, I hope it will give details on DBT and Mentalization Therapy for BPD, which it claims it will do -- but I will be reading with my critical thinking cap firmly in place and an awareness of the author's apparent bias in her writing. She is the president of TARA-NPD, an organization which appears to be doing good work in promoting research into BPD, but her personal focus seems to be on "Advocacy" for BPD suffers, which seems to mean she tends to overvalue their emotional pain and undervalue the emotional pain they cause in others. They are sick, they can't help it, therefore they cannot be held accountable for anything they do, and pulling away from them to save yourself is mean, cruel, and will make them worse, and you are a bad person who is lacking in compassion if you make the decision to go LC or NC with the BP in your life. Saving yourself is not acceptable; you must go down with the ship. Now, perhaps she will discuss healthy and safe disengagement later in the book, in which case I will be sure to post a follow up here, but so far I've seen no sign of that.

Oddly enough, although she supposedly has an MA, I haven't been able to determine what her degree is actually in, whether it is a mental health or social work field or something unconnected, and where she received it. I tried to call TARA's "hot line" but they may not be manned on weekends as I got voice mail.

A week or so ago I Googled "Honor Thy Father and Thy Mother abuse" to see what spiritual "authorities" said about the issue of "honoring" parents who damage their children. The best answer I found came from http://www.chabad.org/theJewishWoman/article_cdo/aid/1195265/jewish/Emotionally-Abusive-Mother.htm, which gives the liberal Jewish perspective and comes down with: When a child is being abused, the law of Honoring Your Mother and Father is suspended. It was the most sensible religious perspective I found on the issue and I was impressed with the response. (I'm not Jewish, this just happened to be where the Google search led me.)

In any case, it seems clear to me that children of BP parents have an enormous burden to deal with when it comes to society's expectations of how one should behave towards one's parents, and need a lot of support in this area to deal with all the invalidating messages they get. I am disturbed to find this "expert" book alternately dodging the question or obliquely supporting the idea of "Hey, they're your parents, you owe it to them to take what they dish out without complaint." In the opening section of this work, on p. 23, Porr states that having a parent with BP requires "forgiveness, compassion, and acceptance" on the part of the child (from a child? Seriously? How old a child?) and states "It is certainly not fair to a child to have a parent with BPD but unfortunately this is the way it is. Surely there are some positive qualities in the parent, and a great deal can be gained by accepting that the parent with BPD is doing the best he or she can." And that's where she ends the (short and perfunctory) section on having a BP parent. "That's the way it is. She/He is doing the best he or she can."

What if that's not good enough, Ms. Porr? We take children away from parents who cannot do well enough for them physically or economically. Should we not also remove children from parents whose "emotional best" simply is not sufficient for their children's needs? Do you tell a child whose parent allows her to starve, or to freeze in the winter without adequate clothing, that "That's the way it is, he/she is doing the best he/she can for you"? If you would not tell a starving or freezing child that, why would you tell an emotionally starved or frozen child that? I have to say I don't get it.

In "Understanding the Borderline mother" the author uses the drowning analogy as well. She say's something along the lines of how children need to understand that the pwBPD is in a sinking ship and that in order to survive they need to swim to shore.

That's fascinating. I haven't read that book yet because it wasn't available in the local bookstores and I have it on order at the local library, but I came up with the drowning analogy completely on my own, to the best of my knowledge. (I mean, I may have dredged it up from something I read somewhere else at some point, but it wasn't that other book and it wasn't conscious on my part.)

As soon as this book comes in I will move it to the top of my reading list.

[Maytree]

Just wanted to update: I got and read "Understanding the Borderline Mother." Excellent book, although I think the author is a bit too wedded to her four "classes" -- while I can certainly see aspects of my Mom in all four of her archetypes, my mother, at least, tended to change aspect a lot and frequently. (If I had to classify her using these four archetypes, though, I would say she was a Queen/Witch while I was growing up, and now that she's elderly she's mostly Waif and some Hermit.)

But in any case, Christine Lawson definitely used the "drowning person" analogy HEAVILY in her book, which amazed me. It's enough to make me think maybe Jung's idea of the "collective unconscious" where some symbols have universal (or nearly universal) meaning might have something to it. Or maybe it's just that the drowning analogy is such an elegant fit to the situation with BPD (and other personality disorders) that people just kind of gravitate toward it naturally.

 (As a side note, I'm currently reading "Emotional Blackmail" by Susan Forward, and Forward indicates that many people who resort to emotional blackmail tactics out of desperation -- which would include the vast majority of borderlines -- evoke the image of the internal "black hole," the abyss hovering just outside of themselves waiting to swallow them up.  She points out that these people all came up with this image or concept on their own, without consulting each other, and they all have essentially the SAME image and use the same idea to describe their feelings. So again, is this the collective unconscious, or is the image just such a good fit that people gravitate toward it?)

[ShadesOfGrey]

Honestly, I think the author is BPD. I found this book goes against everything, as non's, we are taught. It says not set boundaries, ask the BPD for advise and so on. I understand being empathetic to BPD's but this book often suggest you put their needs in front of your own. If this book is for parents with BPD children, it was not apparent to me as the reader and as an adult child of a BPDm I found it ridiculous. She often just says BPD loved one, meaning this could apply to anyone we love with BPD. If you have a child with BPD I think it might be somewhat helpful, but I still disagree with a lot of it. People, including BPD's are only as rational as you make them to be by setting boundaries and keeping them in your reality, not theirs. The author goes on to suggest you learn how to do dialect behavior therapy on your BPD to help them. She gives suggestions on how to validate them, and help them, then goes on to compare the non's life to a missed vacation in Italy. We didn't plan on having a BPD loved one and should just get over it, life isn't always what we plan, like the person who planned to Italy but ended up in Holland, really?

[united for now]

   

This book is a good read if you have children or other family member who suffers from Borderline Personality disorder, and you are seeking ways to heal and better understand your BPD loved one.


Ms. Porr is President/Founder of the Treatment and Research Advancements National Association for Personality Disorder (TARA NAPD), a not for profit education and advocacy organization representing consumers, families, and providers affected by BPD. Valerie Porr worked with Dr Marsha Linehan, developer of Dialectical Behavioral Therapy (DBT), and has developed a curriculum combining DBT and Mentalization teaching family members how to help their loved ones with BPD while helping themselves. Ms. Porr conducts educational seminars and Family DBT Coping Skills Workshops, trains family leaders, speaks at family and professional conferences, and has coordinated BPD research conferences with the support of the National Institute of Mental Health.

[More than sad]

Valerie Porr's Overcoming Borderline Personality Disorder:  A Family Guide for Healing and Change is
the best book I've read on BPD.  She gives guidance based on evidence and real studies.  Much understanding for both the
individuals with BPD and their loved ones. 

Lots to learn and specifics with how to cope and make relationships better.  Helps demystify their actions and understand your own pain.  Indeed, helps you truly walk in their shoes and feel their pain.  Also, latest research on what is really going on in their brains.   Makes the DSM criteria really mean something.

Below is a review from the Chief of Staff at Menninger--one of the best clinics in the US for treating BPD.  It's said that Menninger is the Harvard of mental illness treatment and Hazelden is the Harvard of addiction treatment.

"Overcoming Borderline Personality Disorder by Valerie Porr is like water for a parched land. Few psychiatric disorders are as misunderstood as borderline personality disorder, a condition that can be profoundly disabling to patients and devastating to families. Opinions about what families should do are plentiful, but evidence-based guidance, derived from solid research, is rare. This is what this book delivers. It is an invaluable roadmap for families of patients with BPD."--John Oldham, Chief of Staff, The Menninger Clinic

[Reality]

Yes, heronbird told us that Valerie Porr's book is her favorite, so I kindled it immediately.  Like heronbird, this is also my favorite BPD book.  Compassionate AND intelligent!
Reality

[peaceplease]

I will have to add this to my collection.  I felt that I had enough of books about BPD, but I keep reading about it on here.  I guess that I am meant to get it.  Is this a book for pwbpd to read as well?  I gave my dd three books: The Angry Heart, Get Me out of Here, and The Buddha and the Borderline.  The only one that she actually  read and  enjoyed.  She said that she could relate to the girl in the book. 

My first book was, Stop Walking on Eggshells, and that was a tremendous book.  Then I got the essential family guide.  And, I have ,"I Don't Have to Make Everyone all Better."  I know that is probably not the exact title.  But, that last book really helped me with setting boundaries. 

I believe that I did put it on my wish list at Amazon.  I will be ordering it soon.

[heronbird]

Haha, yes my second bible. I was reading it at the hairdresser the other day, Im nearly at the end, I read three pages in 45 mins, I know I am a slow reader but I have to really think about what she says so that it goes in. When I finish the book I will start again.

I take photos of some of the pages and send them to dh, because he does not  seem as interested in it as me. So thats been helpful for him. Also my other d who is 22, non BPD. I emailed her a copy of two pages after she had had a terrible argument with bpd sister the night before, older dd took it personally at the time.

Theres a bit under the subject prementalisation, saying how their thought patterns become rigid, gosh so true.

Im liking the bit on MBT now at the end of her book. Dr A Bateman devised MBT, I have written to him to ask if he will speak at a group, I would love that.

Also, email TARA, they will send you news letters, so interesting

[heronbird]

Peaceplease Hi!
Wow, your dd read those books, thats so good, my daughter goes crazy most times if I suggest her reading or looking for info on BPD. Maybe she will when she is older.

I wouldnt probably give her this book. I would try to find one that was specially for her.
We did watch the film Girl interuped, have you seen that, so so sad

[Reality]

Heronbird,
The Family Psycho-educational facilitators handed out information to us at the first session.  In that first hand-out, there were three book excerpts, one from your favorite Valerie Porr and also from one of my favorites, Joel Paris, a Professor at McGill university in Montreal.  They spent time elucidating the criteria for BPD and then guess what heronbird! The Tara tiara, although they didn't name it as such.  What is interesting is that they had a definite stance on medication, that once pwBPD have the necessary DBT skills, they wean themselves off medication.  They also stated that medication isn't typically prescribed for pwBPD.  This course was presented by the Canadiam Mental Health Association using Camh materials. 
Camh is a world-renowned Addiction and Mental Health facility associated with the University of Toronto and still, qcaroir the BPD clinic is relatively small and seriously under-funded.  The wait list was only open for part of one day in October.  They had to close the phone line at 200 callers mid-afternoon.  I was lucky I had phoned the month before and that my son was willing to phone right at 8 o'clock when the phone line opened.  Still, remember that my son's diagnosis was missed a year ago, at this same world-renowned facility, 2 floors down from the BPD clinic.  Resources are sparse here too.  As well, I dx'd  him in September and we didn't get an assessment until mid-January, a wait of 41/2 months.  Plus, the wait list for the year-long program is so long that he is just doing 20 weeks of Skill Training, which everyone agrees is not long enough.   The DBT therapist is private and we pay $130 a week.  I have found one private BPD  clinic, where my son can do more Skills Training when the 20 weeks is over.  Very limited resources here too.
My dh and I were agreeing yesterday that my son needs a residential facility, with comprehensive DBT.  If my son is not successful with the outpatient program, we will have to consider this very expensive option, which will be questionable financially, as you may recall that I retired earlier than planned from my career. 
Reality

[Battle Weary]

Reality,

Getting a dx can be challenging here timewise as well.  It takes a lot of effort to find someone who is competent at dxing borderline and not inclined to call everything bipolar.  Then one can find long waiting times for these doctors because the good ones have such full calendars. One often hears teaching hospitals are the best places to go, but their waiting lists often are so full you can't even get on them.

DBT may be a bit easier though it is private pay with a gamble that insurance might cover part of it.  In the city where I live we are fortunate to have four adherent DBT providers, some of which also offer skills training.  One place warns their waiting list varies from three months to a year.  A lot depends on a slot opening up because someone else is completing the training.  I have been fortunate to get my dd pretty quickly into a DBT therapist because I inquired with the place right after they had hired her but before she'd come on board.  (This was after failing at two other places because DD was refusing the group component.) This week I will deal with getting her into group--her new T convinced her to go after two individual sessions.  I have no idea how long it might take to get the group component into place. 

The other maddening part about the paucity of programs is that everyone seems to agree that the most critical element of therapy is the fit between the patient and the therapist.  Given the scarcity of spaces, good fit seems like an afterthought luxury few can actually get.  Fortunately, dd seems to really like the new T--she looks like she is in her thirties and dd is comfortable with her as a kind of older sister figure.  In a way, it's good the other places didn't work out as she would have had an older woman as her individual T and she would have found it intimidating. 

This seems to be working out but only by lots of effort on my part and a large dose of serendipity.  This really doesn't seem to be a way to run a railroad!  And it sure doesn't look like Canada or the UK are doing it any better.

[heronbird]

Battleweary, the book talks about some of the things you mentioned. I think she says they prefer to call bpd bipolar in US, its to do with your insurance.
I like what she says in the book about the patient and therapist, she talks about how if the patient does not get on well in therapy they may it didnt suit her or she was a bad patient. but she compares it to another illness, it the kidney dialasis machine was not working on that particular patient, they would find out the reasons and do something about it, not just write the patient off.
She explains it better of course in the book.

[peaceplease]

heronbird,

The only bok that my dd actually finished was, "The Buddhas and the Borderline".   She is not much of a reader, and the other books did not hold her interest. 

[heronbird]

Ha, well you know I hate reading, Im not very good at it, so its quite funny how much I have had to read since having children.
I was humilliated at school when I was young repeatidly by my teacher in front of the class when it came to reading, so Ive never much liked it, but its such a special gift and so helpful. I find it so hard to be motivated to turn the tv off and read haha.

I am at the end of Valerie Porrs book now and it is very interesting reading about mentalisation.
Battleweary, we were lucky when we got diagnosis, dd was admitted to hospital in crisis for first time, for some strange reason they put her in the best psychiatric unit in UK, no one knows why that decision was made at that time but we ended up with a brilliant psychiritist and she got the diagnosis within a week. Wheras no one had ever diagnosed anything, and I thought I was imagining it all.

Reality, what is camh?  We have camhs over here I thought maybe similar. it stands for child adolessant mental health I think.

[Reality]

Camh is the Centre for Addiction and Mental Health.  It is well-known, but unfortunately, heavily funded by pharmacological companies and so BPD doesn't get a lot of funding. 
Reality

[qcarolr]

I am slowly getting this book read. I too am reading it slowly and thinking about it. The part the hits for me is how I can learn and change how I deal with DD, and this will help her become more accepting of that DBT is not like all the other threapies that have been so un-helpful for her.

DD was dx bipolar and ADHD as a very young child - age6. So many drugs we tried, so may therapies and accomadations. All only seemed to make things worse. This book really highlights this effect - the detrimental effect - of other therpies on pwbpd. The 'wrong' T is not a benign thing - it makes things worse. And I know my own crap was not that helpful either. Yet - I can work to let go of all that, work to help DD know that there is hope and she can let go of much of that -- only time will tell. But things are better here.

But maybe that is her motivation to stay out of jail with somewhat trumped up DUI charges - she is staying clean and sober to meet her bond monitoring requirements. And she is so much nicer to be areound

[More than sad]

I understand that some will have problems with what Ms. Porr has to say.  Reading some of it I said, no way.  Then I thought
more about it and tried what she suggests.  It works when nothing else, nothing else I've tried worked.  Validating my son's feelings
first made him positively "light" up.  Someone understands; finally someone understands.  We parents were trying to reason from logic
and were being met with pure raw emotion. 

There is a saying somewhere about it is impossible to be angry with someone who understands you. 

The book has so much that is counter intuitive to people without BPD but what I have tried from her suggestions works.

I guess one of the biggest blessings in the book for me is the journey into their psyche.  I finally get a lot of where they are coming from and understand so much better what they are trying to cope with.  The description of juggling the balls is so powerful.

[mikmik]

Reality,

Funny how these threads twist and turn.  How this came down from May's review of the book, to Heron's.  I am curious about Valerie's book, and also the Buddah book as well.  The twist comes from the intended reader I think.  Being a child of a BP or the mother of a BP are very different things.  That is where the differing view comes from I am guessing.  Makes me wonder, as several of us parents are not yet grandparents, my-oh-my, it is scary to think of the cycle continuing...

I am VERY interested in the fact our P told us that therapy will be a more effective than meds.  I am wondering if I should be approaching the T and P about "weaning", or is that only after years of therapy?  What is your take on getting them off meds, and could these meds be an underlying cause of other issues?  Could the meds actually be counter-productive with the BPD mind?  I wonder how much they are contibuting to my dd18 sleep issues and current lack of any motivation?

Guess it is time to add to my sparce BPD library..looking forward to hearing your feedback on what you learned about the meds, as well as any other parent's experience with getting off meds (albeit this a a book review thread...if it is better to start a new one, let me know)

mikmik

[Reality]

mikmik
This is definitely a new thread, but I wanted to send you a note to give you a few details.  My stance is rather unique here on this message board, I believe.  Medication scares the living daylights out of me, mikmik, even more than the soft street drugs, which sounds rather weird, I know.  The potential to overdose seems much higher with pills, that are readily available.  I am trying to be honest, so you have an idea of how to frame my comments. 
As noted above, the DBT therapists leading my family group indicated that their clients tend to wean themselves off medications, as they master new skills in emotional regulation and distress tolerance.  As well, Joel Paris, a leading authority on BPD says that often medication isn't useful, except for SSRIs in some cases.  That has always been my intuitive stance, as well. 
The lack of motivation comes from isolation+discrimination+bad luck+lack of structure+emotional dysregulation.  So much energy is spent regulating emotions, there is nothing left over.  Period.  Any shift in those root causes helps the sufferer, ever so sloooooooooooooowly. 
The sleep issue, I think, is a BPD constant, connected to the emotional dysregulation.  Without strenuous exercise and a rigorous daily routine, it is a difficult one to regulate.
I strongly endorse the efficaciousness of DBT Skills Training and DBT therapy or Schema Therapy or Mentalization therapy.  I also think if there is a compassionate, dedicated community experience with honest and intellectually talented workers, the same help can be found.  I mean a kind of out-of-the-box kind of place. 
I do think the spiritual wasteland that is our modern culture plays into this disorder as well, somehow.  It is a tough world out there.  At least, up here, in Canada!
I don't know if this is any help.  Just rambling...
Reality

[heronbird]

Oh gosh, would anyone not like some of V Porrs stuff in the book? Ive nearly finished it and I cant see anything there at all that is not good, Id like to know what you think might be questionable as I like to see both sides of the coin Thats DBT isnt it I learnt that from the book too haha.

I also like it when she says about we have all joined a club that nobody else wants to join, how true and we never wanted to join it either.

Also about how watching our loved ones is like watching them with a big tidal wave coming in and we are helpless to do anything, we watch helplessly and hope they will be ok. She writes it better.

She also says do you resent changing everything for your person with bpd, but you wouldnt think twice about changing everything if they had a physical problem, ie putting in a ramp and using a weelchair etc. This helped me a lot too.
Oh yes, also, I done a possitive psychology course last year and they definitly say meds are not that good compared to the therapy, it you get the right therapy then forget medication.

[qcarolr]

I have gone back and read this thread from the beginning - I needed to get perspective on the book from the reviewers that survived childhood with a bpd parent. I needed to balance this, and something kept popping up from the very beginning of Valerie's book.

In the Preface, on pages xv "What is Psychoeducation:" and xviii "TARA's program..." are the comments that help me to put this book into perspective. I do appreciate all I have read so far about the neuroscience of BPD and using research based therapies to manage life when we choose to stay connected to the ones we love with BPD. That choice is still always there -- we do need to do our own work to have the courage and strength to be in this relationshiop. Valerie never denies this need on the part of the family members to take care of themselves, and that they have struggled long with much dysfunction in their lives.

So what does this Preface say about her book -- it says this guide is putting the 'patient outcome' as the first priority and the 'family well-being' as the second priority. She also refers to Dr. John Gunderson's guides to living with someone  with BPD, which is one of the resorces here at FTF. My dh and I read this article back in early 2010, soon after we had taken out the restraining order to keep DD from coming back to our home - after 'abandoning' her in jail after she was attacked by her bf - she fought back - they both ended up with assault convictions - his a felony her's a misdeanor. DD still brings this up, I repy that I did what i had to do and move to a new topic or walk away.

 So if I keep this preference in mind as I read the guide to BPD treatment, it helps me to know that I still am "OK" to be taking care of myself as needed along the way.  If I do not survive, then surely I will not be here to help by bpdDD25. I have been on this BPD journey since she was dx at age 23 in May 2009. I can say only in the very recent past have I gained enough healing within myself to be able to accept Ms. Porr's viewpoint in handling my DD with bpd with sincere validation and a focus on boundaries to protect my values and r/s's with others in the family - vs. boundaries with expectations to change bpdDD.

I am continuing to work my way through this book. So many great comments -- all give value to each of our journeys.

qcr xoxo

[qcarolr]

I read more of this book last night. Truly I found the theme of the family members need for healing and recovery brought in many times.

For me, I think that I have needed to do much for myself over the past 3 years to be at a place where I can PRACTICE THE COMPASSION LEVEL REQUIRED for impacts of the changes in my actions to have an impact on my interactions with DD25. For this process to feel 'right' to me.

I had to work and work with the radical acceptance pieces - and Ms. Porr approaches the DBT stuff from 3 directions - the pwbpd, the therapist, and the family. Each party involved has to do the work for ultimate success. And the focus for each involved has a slightly different twist.

Think I will be reading some part again after I finish the book.

Also need to be kind with ourselves as this is all a process.

qcre xoxo

[heronbird]

I saw a short story today on tv about a lady who has a son with adhd and she is trying to educate everyone to say that its not from bad parenting as she has two sons and one is fine.

They had a P on the show too, they asked her how you can help these pw adhd, the P said the best thing is called multi disciplinary help, so teacher, parent and the child all work together, thats the best way to have success.

Why cant we have that, adhd seems so similar to bpd yet I know they are different, she said her son does not want to do what he does and that he has moments where he is like just normal and kind loving and funny.

Im just saying that because you said the book approaches the DBT stuff from 3 differern directtions, seems similar eh.

I never felt like school wanted to work with us and we were not getting much help from P either actually. So not much chance there, glsd dd is not at school anymore, much easier.

[qcarolr]

Heronbird - Ms. Porr emphasizes the vital important of a team approach to bpd treatment over and over and over. Each part needs a support team in the background. The pwbpd needs a DBT therapist to work as a coach plus the DBT group and skills class. The T needs a support team for consultation and to keep from having burnout. The family needs supportive family, friends and T of their own to be able to persist in the hard work of compassion day after day.

And yes, it is so hard to find all these peices together in one place. So we have to do the best with what we can put together.

qcr xoxo

[Anguish]

possibly written by an enabler.

It does sound very much like enabling. Speaking from my own intensive personal experience, enabling is the worst possible way to deal with BPD. It makes everything a hundred times worse. Ms Porr may well be an expert but this does not mean she is infallible. No one is unfallible.
Just last century, medical experts were recommending all sorts of things we would never use now (such as smoking cigarettes to calm you down!), and as time goes on I'm sure there will be updates on dealing with BPD.
The real experts in BPD are those who have to live with a BPD loved one.

[heronbird]

qcarolr,

You wrote that a while ago, I think everyone agrees that pwbpd need a team. Wheres my dds team? She has a psychiatrist that she hates and never sees. Then a care coordinator, that is not enough, she needs t.

They say they are assessing her, I will be ringing up about that when care coordinator comes back from hol

[Forgetmenot]

I'm  only part way through this book.  It is bringing some of my own sanity back.  Stories that describe by D17 to a "T".  All the advice I've gotten about being a bad parent, not strict enough,etc.

All I know is that normal parenting techniques don't work.

I have always wondered if it is a can't or won't situation with her.

Now that I understand the pain she is feeling my mind is racing with ways I can change my habits in little ways that will help her, even if she never goes to therapy.

Now that I know she isn't a she=devil and that with a lot of work and effort there is hope I think I can give it another go around.  She is a beautiful girl, inside and out and her behavior has been mindblowing and exhausting for the whole family.

I can't tell you all how much I appreciate the help I have been getting on this forum.

At this point she isn't speaking to me or answering my emails.  I'm not sure if it is because her dad has her on total lockdown or now.  My son will find out what is going on for me.

If I can educate my immediate family  about some of her needs, simple things like answering her texts.  Or texting her just to say hi once in a while would go a long way to help her become dysregulated less often.

FMN

[heronbird]

Im sure it is because I read this book that I still have an ok relationship with dd. She keeps coming home and talking to me, her sister also has learnt lots from the  book, now dd loves her sis a lot more.

Yes, I think if I hadnt read the book, I would not have learnt so much.
This site is so good too, so helpful and supportive, its great.

[Forgetmenot]

Maytree,

You have some very valid points about this book.  I suppose it would depend on what your purpose for reading the book is.  Are you trying to help a child? is it a parent relationship?  spouse?

With the help of this book I was able to understand the workings of the mind of my d17, to understand why she can't swim so to speak.  I don't think I can save her, only she can do that.  But by learning how to keep myself from churning the waters near her and to keep her from going into panic mode it can be helpful to her, thereby, increasing her ability to save herself.

I do agree, a lot of people with BPD are just plain abusive.  If anyone treated me the way my d17 does they would be gone from my life in an instant.  But I do feel a responsibility to give it the best try that I can.  Eventually, she will have to sink or swim and for a parent it is incredibly painful to watch.

And I agree, the book is lacking on coping strategies for keeping yourself sane and setting boundaries.

BPD in children should be handled differently than in adults in my opinion.  In children there seems to be a fine line between enabling and helping them keep regulated.  In adults, walking away is a valid option.

Overall, I found this book to be quite helpful, mostly to gain insight as to what is actually driving the behaviors.

[heronbird]

Yes I just read Maytrees posts, well most of it but got the gist  of it and I like to try to be open minded and see both sides of the coin but I cant in this issue.

I have to say, while we as carers suffer a lot, times it by ten thousand how our loved ones feel. Someone once said that having depression is like having the worse tooth ache ever times it by thousands.

Yes sure, my son broke his knee 6 weeks ago, everyone askes him, how is your knee, do you need help, do you want a lift, shall I get you a foot stool, do you need more pain killers etc etc. No one asked me how I felt, he was a pain in the neck, I had to put his sock on and take it off at the end of the day eeeeyuck. I had to make him coffees and lunch, organise lifts etc etc.

So while I recognise carers suffer, I feel for the person who is ill much more, and I have managed to stop my daughter being abusive towards me and the family through reading this book, quite honnestly, Id read about 5 books before Valeries and yes they were good, but nothing much changed with our relationship.

I have managed to get my daughter from rage and abuse because she couldnt find a sock, to calm within about 2 minutes.

After reading the book, I tried to read another BPD book, and it was too basic for me.

So what if she does not have a degree in mental health, she obviously knows her stuff, I dont have a degree, but I know more about BPD than some psychologists I have met. My daughter has a degree in psychology and masters with distinction in Mental health, I still know more than her about BPD. I just dont have the paperwork.

I dream of going to New York one day and doing a course at TARA. Hi!

[Forgetmenot]

Overall, I found that book to be a lifesaver...but it didn't answer everything.

My relationship with my d17 is 1000% better because of this book.

What I struggle with is setting boundaries.  But I find that when I do successfully set a boundary...her mood returns to baseline.

I'll post that story under the helping kids with bpd.

[heronbird]

Yes, Ill check it out.

You are right, the book does not answer everything, I want to know, what do you do when they have taken the OD for example, well I guess it is validate, but dont validate the fact they take the OD. Yes there is a lot of issues that it does not cover.
I want Anthony Bateman to write the same book based on MBT.
I think he said he is going to, Ill check again with him. We could ask him to write some things in it that we think could help.

Oooh, I dont want to start going off the subject now.

[real lady]

I JUST got this book from the library; the first time that I have seen it and have NOT yet begun to read it but I have read through this thread and am impressed that the author worked with Linehan with DBT and has that background. Looking forward to GLEANING more wisdom about the working mind of the pwbpd for my ubpdh.  xoxo

[mikmik]

I finished the book a couple of months ago.  There is sooooo many important mind-saving concepts, that I started reading it again.  This time, I am making notes in the margins.  I got turned onto this book thanks to Heronbird.  Thanks again friend!  After this go through, I suspect it will be worth a third read.

Looking forward to hearing about Bateman and MBT.

mik

[real lady]

Started reading this book and I can say that I wish that I had read this book a year ago.

I would put it AT THE TOP of any recommended reading since it is SO THOROUGHLY helpful to the NON to understand HOW and WHY (in some cases) our pwbpd behave as they do. Learning about the physiology of the brain and understanding the physical basis of this illness is REALLY helping me.


BPD is NOT ABOUT ME..it is about my ubpdh's behavior and WHY HE behaves as he does...what I need to learn is how to "read" him and to provide validation when needed and to NOT TAKE THINGS PERSONALLY (as he personalizes EVERY THING) in helping to make a better life for us with "what we have right now". I also understand in a more indepth way why he may not "be able" to accept that he has a mental illness and he experiences about 9x more psychic and emotional pain and only feel 1/2 the amount of joy that I do. 

[heronbird]

Thankyou Mik, Im so glad if I can help anyone, and yes I need to re read it and learn it all off by heart. It has been a really good book and I say it is the reason that I still have a relationship with my dd. I dont always get it right but the tools that I have learnt from the book are so helpful.
The only thing I wish is that I live in NY and could go to TARA and attend some meetings there.