Stop Walking on Eggshells

Your therapist may have recommended Stop Walking on Eggshells. Therapists will suggest that you read this book to see if the description sounds anything like your mother (or child, or relationship partner). Stop Walking on Eggshells was one of the first books for the general public on Borderline Personality Disorder and has sold over a half million copies and has been published in nine languages.  It is currently in its second edition, updated in 2010. 

This is a beginner's self-help guide. The book looks at the complex emotions that family members go through. It explains how the disorder affects you and what you can do to get off the emotional roller coaster and take care of yourself.  This book includes common questions and answers about Borderline Personality Disorder. It also contains ten steps to help the reader better live with and accept someone who suffers from this disorder. The book covers how to choose a therapist, support group, and book resources, too.

This is a sympathetic, blame-free, and simply-written book. For example, the authors explore BPD behavior in terms of manipulation vs. desperation and conclude that people with Borderline Personality Disorder often do not deliberately and consciously manipulate. Rather, they tend to become emotionally desperate in their panicked and frantic efforts to connect with others.

The book is divided into three parts.

1. Part One is Understanding BPD Behavior.  This section provides much needed validation and vindication to children of people with Borderline Personality Disorder who need perspective to understand their BPD parents’ inexplicable behavior. Many people with Borderline Personality Disorder fluctuate between extremes of idealization and devaluation, otherwise known as “splitting”, which is an unconscious defense mechanism.

1. Part Two is labeled Taking Back Control of Your Life.  This section explains how to make the necessary changes within yourself.  You can lead people with Borderline Personality Disorder to treatment but you can’t make them well or feel better; that is up to them.  It clarifies the illogical basis of a person with Borderline Personality Disorder's self-denial that a problem exists, and sheds light on the fact that people with Borderline Personality Disorder will seek help when they feel the benefits of doing so outweigh the obstacles in their paths of change.

1. Part Three focuses on Resolving Special Issues such as coping with the borderline child. The book acknowledges that different types of relationships are affected differently by BPD.

One interesting aspect of the book is the authors' discussion about the four stages family members often go through in making sense of it all. We have seen this happen many times here at BPDFamily.com:

1. The Confusion Stage. This generally occurs before a diagnosis of BPD is known. Family members struggle to understand why borderlines sometimes behave in ways that seem to make no sense. They look for solutions that seem elusive, blame themselves, or resign themselves to living in chaos. Even after learning about BPD, it can take family members weeks or months to really comprehend on an intellectual level how the borderline person (BP) is personally affected by this complex disorder. It can take even longer to absorb the information on an emotional level.

1. Outer-Directed Stage. In this stage, family members typically turn their attention toward the person with the disorder, urging them to seek professional help, attempting to get them to change, and trying their best not to trigger problematic behavior. People at this stage usually learn all they can about BPD in an effort to understand and empathize with the person they care about. This leads to the acceptance that the BP does not think and react as the family members expect or would like them to.

1. Inner-Directed Stage. Eventually, family members look inward and conduct an honest appraisal of themselves. It takes two people to have a relationship, and it is important for family members to better understand their roles in making the relationship what it is now, and what it can be. The objective here is not self-recrimination, but insight and self-discovery.

1. Decision-Making Stage. Armed with knowledge and insight, family members struggle to make decisions about the relationship.

1. Resolution Phase. In this final stage, family members implement their decisions and commit them.

Paul T. Mason MS is a program manager of Child/Adolescent Services and a psychotherapist with Psychiatric Services for St. Luke's Hospital in Racine, Wisconsin. His research on Borderline Personality Disorder (BPD) has appeared in the Journal of Clinical Psychology, and he teaches seminars for mental health professionals on the effects of BPD on partners and family members. 

Randi Kreger is a professional writer, and co-author of The Stop Walking on Eggshells Workbook (2002), The Essential Family Guide (2008), and  Splitting: Protecting Yourself While Divorcing a Borderline or Narcissist (2011). Kreger blogs at Psychology Today. Ms. Kreger is also a professional member at BPDFamily.com. 

Read about the experiences of BPDFamily.com members with this book here.

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Excerpts:

1. The Intensity of BPD Behavior People with BPD feel the same emotions other people do. They do many of the same things that other people do. BPD does not cause fundamentally different behavior but behavior that is very far to one side of the continuum. The difference is that they:

• feel things more intensely
• act in ways that seem more extreme
• have difficulty regulating their emotions and behavior

1. To Tell or Not to Tell?  As you read this book, you may be eager to talk about BPD with the person you think has it. This is understandable. Learning about the disorder can be a powerful, transformational experience. The fantasy goes like this: the person will be grateful to you and will rush into therapy to conquer their demons. Unfortunately, the reality differs. Family members repeatedly told us that their loved one instead responded with rage, denial, and a torrent of criticism. Frequently, the person with BPD traits accused the family member of being the one with the disorder.

1. Seek Help From a Qualified Therapist  The issues here are complex. Don’t rush into anything. Discuss your thoughts with a qualified therapist who is experienced in treating people with BPD. Generally, it’s preferable that the person learn about BPD from a therapist—not from you. If the person is an adult and is currently seeing a therapist, the therapist probably will not discuss BPD with you because of confidentiality laws. You can, however, share your concerns with the counselor. It’s likely that other people in the person’s life may also respond with denial and accusations, especially the borderline’s family of origin: his or her mother, father, and siblings. Keep in mind that it is not your job to convince anyone of anything. People have to be ready and willing to learn.

1. Don’t Get Stuck on the Diagnosis  Rather than dwell on the diagnosis per se, help the person see that in any relationship, both people bear responsibility for the way things are. (You may feel that the BP is responsible for all the problems, but set this aside for now.) Your message should be that when there are problems in relationships, both people need to work on them together. If the person with BPD cannot seem to take a cooperative approach to working on the relationship, you may wish to simply focus on setting limits (chapter 6).

1. Know There is Hope  BPD is probably the most misunderstood psychiatric diagnosis. And the biggest mis-perception is that people with BPD never get any better. In reality, medications can help reduce depression, moodiness, and impulsivity. Certain treatments have been shown to be effective in empirical research. We have met many recovered borderlines who no longer feel compelling urges to hurt themselves, who feel good about themselves, and who give and receive love joyfully. What if the BP refuses help and treatment? There’s still hope. Although you can’t change the person with BPD, you can change yourself. By examining your own behavior and modifying your actions, you can get off the emotional roller coaster and reclaim your life.

1. Lacking a Sense of Self A sense of inner emptiness and chaos renders borderline patients dependent on others for cues about how to behave, what to think, and how to be; whereas being alone leaves them without a sense of who they are or with the feeling that they do not exist. This, in part, accounts for these patients’ frantic and often impulsive effort to avoid being alone, as well as their descriptions of panic, crushing boredom, and dissociation.

1. Self-Mutilating Behavior  Sometimes, dangerous or compulsive behavior can be a type of self-mutilation—overeating to the point of obesity, for example, or provoking physical fights with others. Self-injury is a coping mechanism that BPs use to release or manage overwhelming emotional pain—usually feelings of shame, anger, sadness, and abandonment. Self-mutilation may release the body’s own opiates, known asbeta-endorphins. These chemicals lead to a general feeling of well-being. Self-mutilation can become addictive, much like smoking, and the urge to do it can be just as powerful as a smoker’s urge for another cigarette.

1. Manipulation or Desperation? It’s no secret that non-BPs often feel manipulated and lied to by their borderline loved ones. In other words, they feel controlled or taken advantage of through means such as threats, no-win situations, the “silent treatment,” rages, and other methods they view as unfair. We believe that, in most cases, the BP’s behavior is not intentionally manipulative. Rather, this kind of behavior can be seen as desperate attempts to cope with painful feelings or to get their needs met—without the aim of harming others

1. Real-World Types of BPD People with BPD vary a great deal in their ability to work inside or outside the home, cope with everyday problems, interact with others, and so on. This variation is one reason why BPD befuddles those trying to define it scientifically. In The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells (2008), Randi Kreger, coauthor of this book, developed a real-world, way of looking at these differences. She writes that there are three general categories of people with BPD: lower functioning, “conventional” BPs, higher functioning, “invisible” BPs, and those with characteristics of both. The challenges family members face can be very different.