Community Built Knowledge Base => Library: Content to critique for possible feature articles => Topic started by: DearBFF on July 29, 2015, 07:44:32 PM

Title: 10 articles: Responding to Parental BPD Provocations - David M. Allen M.D.
Post by: DearBFF on July 29, 2015, 07:44:32 PM
10 articles: Responding to Parental BPD Provocations
David M. Allen M.D.

Your choices are not just limited to these two: 1) To either to continue to be mistreated, or 2) to cut off all contact with your family.

A third choice is to change the nature of your relationship with your parents so that you are not being mistreated but are still in contact with them. Impossible, you say? I disagree. While you do not have the power to "fix" your parents, you do have the power to fix your relationship with them. If you change your approach to them in a consistent manner, that will force them to change their approach to you.

However, there is a big problem that you will face in doing this: since you have been in a relationship with them your whole life, they have developed a whole repertoire of behaviors, include recruiting other family members, to give you the powerful message, "You're wrong.  Go back to responding the way you used to."
https://www.psychologytoday.com/blog/matter-personality/201311/responding-borderline-provocations-part-i (https://goo.gl/LYi2am)
What not to do:

A. Try to please the unpleasable. If they put you in a damned if you do, damned if you don't position (a double bind), try to do something to please them anyway. If they "yes-but" all of your suggestions for solving any problem they present to you (that is, if they reject any and all offered solutions with a sentence that has the structure, "Yes, I could do that, but... .), keep offering more solutions. If they ask you to do something that is clearly impossible, try your best to do it anyway.

B. Make sacrifices for them. Stay up all night talking with them on the phone and trying to reassure them about their latest emotional debacle when you have to go to work the next day. Give them thousands of dollars to help get them out of a financial bind that they themselves had put themselves in with profligate spending and irresponsible behavior.

Drop everything you are doing and rearrange your schedule for an entire day so you can do something for them like right now, even though the chances are 50/50 they will not even be there when you get to their abode - and be sure to cancel any planned activity that you've been looking forward to forever that might conflict with your doing so. Drive a hundred miles out of your way to take them somewhere.

C. Get defensive. Say, in frustrated tones, "You know, I'm only trying to help you" or ":)on't you understand that I have other things to do?"

D. Act hostile. Cursing them out is particularly helpful for you in achieving your goal of being a complete failure in their eyes.

E. Act guilty. Because you know down deep you should be able to solve impossible dilemmas, and that their behavior is probably all your fault anyway.

F. Stand there and “take it like a (foolish) man.” Are they slapping you around? Verbally abusing you will a barage of invective?  Impugning everything you stand for? Screaming at you? Just stand there and let them. Maybe they'll stop.
G. Return in kind. I knew a psychiatrist who got so upset with the verbal nastiness of his patient that he told her she was a dog and that she should have consulted a veterinarian. See if you can stop the BPD person's pain-seeking behavior by inflicting more pain.

H. Lecture them. Tell them all about how cocaine is harmful, that they should leave an abusive relationship, or that they should not ride their bicycles at midnight through crime-ridden parts of town in a bikini with hundred dollar bills hanging out their bras. After all, they are just too stupid to figure these things out for themselves. They'll tell you they think cocaine is good for them. Argue the point.

I. Try to rescue the help-rejecting complainer. Go to their house to try to take them away from an abusive romantic partner. Let them move in with you rent free. Loan them money that they will never pay back. Try to mediate their disputes with others (trying to physically get in between two fighting adults is particularly important - maybe they'll both start in on YOU). Cuss out the people who they claim have mistreated them. Go ahead, I dare you.
Tone of voice is crucial. You can use the same, and exactly the right words and sound as if you are indeed feeling helpless, guilty or hostile - or you can sound like you are at peace with yourself and with your own limitations.

Be relentlessly respectful of BPD’s suffering, abilities, and values. Be humble without disrespecting yourself or your own well being. Be honest. Communicate an expectation that someone with BPD will be able to behave in a reasonable and cooperative manner, and play to his or her strengths. And keep it up consistently, or ye olde variable intermittent reinforcement schedule will rear its ugly head.
Countering BPD provocation #1:  Exaggerated over-genereralizations and wild accusations.

A high proportion of people with BPD often make overly dramatic, hyperbolic statements or accuse you of having ulterior motives for whatever you are doing or saying.  When they do this, what they are in fact doing is literally inviting you to invalidate them.

In countering this ploy, the idea is to resist the invitation to invalidate them without agreeing to all the exaggerated histrionics or without agreeing that you are some kind of schmuck. Remember, disagreement and invalidation are not the same thing.

The key: No matter how awful or crazy-sounding what they say is, there is always a kernel of truth in it. Always. No matter how small.

The countermeasure, taught to me by the best professor in my psychiatry residency training program, Rodney Burgoyne, is therefore to validate the kernal of truth in the statement and simply ignore all the exaggeration as well as any negative implications.
Countering BPD provocation #2: Escalating demands on you to do more and more to make them feel better, when absolutely nothing you do or offer seems to help.

Time to declare helplessness outright: "I sure wish I knew of a way to solve this for you." I can say that with deep sincerity, because it is true. I really do wish I could quickly solve impossible dilemmas for people on the spot. I would love to be able to get people out of bad situations after they had already made it impossible to dig themselves out. If I could, I would be able to help so many people.
Countering BPD provocation #3, the use of seemingly illogical statements and absurd arguments.

So the natural response to such statements is to want to argue with what the person with BPD says.  Of course, this is actually invalidating to the person with BPD, because in fact they are intelligent enough to already know what the other person is arguing for. In response to arguing, the person with BPD will then dig in.

If you want to make an obvious point as a springboard for a discussion, you have to use a disclaimer. You have to acknowledge that the person with BPD already is well aware of the point you are making. You might say, "But as you already know, cocaine is destructive in the long run." Or, "Of course you should have the right to do that, but as I am sure you are aware, actually doing it is dangerous. I do not understand why you want to take such a risk." An important caveat is that you want to keep your statements as brief as possible, and NOT go on to explain what you just said or give additional information that justifies your opinion.  

If you do not like that one, you can also just say nicely, "I disagree with you." Disagreement is not invalidation. It does not inherently make one person right and the other wrong. It is just a difference of opinion and nothing more. Many people with BPD have never experienced a respectful disagreement in their entire lives.

Others... .
borderline-provocations-part-vii-parasuicidality (https://www.psychologytoday.com/blog/matter-personality/201406/borderline-provocations-part-vii-parasuicidality)

borderline-provocations-viii-lets-you-and-him-fight (https://www.psychologytoday.com/blog/matter-personality/201408/borderline-provocations-viii-lets-you-and-him-fight)

borderline-provocations-ix-hostile-sounding-comments  (https://www.psychologytoday.com/blog/matter-personality/201409/borderline-provocations-ix-hostile-sounding-comments)

responding-borderline-provocations-last-part  (https://www.psychologytoday.com/blog/matter-personality/201410/responding-borderline-provocations-last-part)

Title: Re: 10 articles: Responding to Parental BPD Provocations - David M. Allen M.D.
Post by: Basenji on August 09, 2017, 01:15:31 AM
A third choice is to change the nature of your relationship with your parents so that you are not being mistreated but are still in contact with them. Impossible, you say? I disagree. While you do not have the power to "fix" your parents, you do have the power to fix your relationship with them. If you change your approach to them in a consistent manner, that will force them to change their approach to you.

In my opinion (which may differ from that others) and based on my personal experiences (which may differ from those of others) there is some useful content, for example:

  • The list of "not to dos"
  • Some of the techniques in handling communication with a borderline

If the author had simply offered the list of don'ts and cited some useful communication techniques, that would be fine... .but the author addresses the whole thing in a narrative of very questionable base assumptions which could be potentially inappropriate (if not damaging) for the victim of abuse by a borderline.

For example:

  • The assumption that you can drive positive change in the relationship without the need to effect fundamental change in borderline. What nonsense.
  • The inference that it is the responsibility of an abuse victim of a borderline parent to drive the changes in the relationship and if they do it'll all be fine.
  • The lack of due consideration for the reality of the abuse victim of the borderline parent (option 3 as defined may not be in the best interests of the victim)
  • The rejection of the possibility that option 3 may not be realistic (it's "not impossible"

The author claims you can change behaviours without fixing the borderline, but then goes on to describe his pet psych theories on borderlines to show why he thinks changing behaviours could indeed fix the borderline!

In my experience the author's fundamental premise that borderlines are altruistic would be an unsustainable hypothesis for the borderline in my life (my mother).

The problem is that without the carrot and stick of "conditioning" to create behavioural change, there is weak if any motivation for change through conditioning. If the author is wrong about an inner altruism, the power of conditioning goes out the window in his model.

I do not personally accept the theory that the borderline has altruistic motivation. The borderline is addicted to martyrdom and self. Everything in their world is seen through the lens of self.

Of course you can sidestep and outwit a borderline to some extent with some communication techniques, but the borderline will always remain fundamentally an abusive person towards the chosen object of their abuse.

The author totally ignores the reality that the person seeking to respond to a borderline parent is most likely the victim of child abuse and thereby is on dangerous ground. Being in a position even to muster a repertoire of communication techniques will likely require considerable progress in self awareness, personal healing, development of non attachment (emotionally), if not substantial non contact.

So the author does not show how option 3 is compatible with the healing journey of the abused. This is a serious failing.

Of course opinions may differ on how to regard the nature of BPD itself - the author appears to rely on the assumption that it is essentially relationship driven. But there may be an underlying genetic predisposition (my mother's Borderline traits manifested at such an early age, I question that it was "caused" by family dysfunction).

The author's ideas are based on his role as a therapist. His experiences and needs differ from those of the abuse victim. Of course the communication techniques trailed and adopted through his professional experience may be useful for some. That said, he appears to fail to show how the approach derived from the therapist-patient interaction may necessarily transfer over to the victim-parental abuser interaction.

IMHO some concerning stuff!

If the author has direct personal experience as an abuse victim of a borderline, or even treating the victims rather than the borderlines (with some evidence that his ideas and techniques work for the victim), I'd consider his opinions more closely.

I certainly wouldn't want that author as my therapist!

(PS. A disclaimer - I'm not trained in psych but have studied biological sciences for over 9 years at further degree level and have 54 years experience of handling a certain borderline person!).

Title: Re: 10 articles: Responding to Parental BPD Provocations - David M. Allen M.D.
Post by: Notwendy on August 09, 2017, 06:14:04 AM
Basenji- it's an interesting choice, and it is the one I decided on. The other two- continue to tolerate abuse or cut them off were not choices I want to make.

I agree that the paragraph makes it sound like it is something one can do without a whole lot of work. It also makes it seem that the relationship would be satisfactory to you- all would be well, which I agree- undermines the abuse and other issues the child of a pwBPD has dealt with. One might say " why is it up to me to change? They are the problem".

The problem with this idea is it doesn't give us something concrete to work on with ourselves. Yes, it would be great if they changed, but we can't change them. We can work on ourselves.

If you change your approach to them in a consistent manner, that will force them to change their approach to you.

There's space for interpretation in this statement. To me the change he is speaking about involves boundaries and reactivity. Reactivity is when our buttons are pushed and we react to them, often in a familiar pattern that places us in the drama triangle with them. Not reacting does not mean sitting and taking it. It means changing our response. Maybe leaving the room, the house, hanging up the phone to get some time out. Not responding in conversations the same way.

Boundaries are not something we impose on them, but on us. For verbal abuse, it means disconnecting from the situation in some way.

I compare this to disciplining a young child. If  a child wants a cookie before dinner and we say no- the child may tantrum, try to manipulate or do something to get the cookie. If we are consistent, the child learns that this behavior will not get him a cookie. Behavior that is not reinforced positively is likely to diminish.

Changing our  patterns in a relationship is something we do for us, but we don't know the outcome. The other person has choices too. They may end the relationship if they are angry at us. It's a risk we have to be willing to take as we don't know how it will turn out.

I had a difficult time with this when my father was alive as I very much wanted a relationship with him. However, if I stood up to my mother, he would get angry at me. Mostly, I tolerated her behavior but got to a point where that was not an acceptable situation to me. My father was angry when I set boundaries on her.

I have been consistent with them and the reactions have been typical. If one thing doesn't work, she tries another. However, over the years, I think she has realized that the old patterns don't work. I don't think she likes it. I also think she is a bit puzzled at the changes I have made. Yet, I also have worked on not taking the road G- return in kind- I don't mean harm to her, yet, she tends to see things that way.

What I did find is that- although my FOO may not like the changes I have made- I do. I like that I can say no, stick to boundaries and not look to them for approval. Would I like approval? Sure, that would be great, but I can't make them approve of me. What I have also found is that my mother doesn't push my buttons as often- she still is the same, but the emotional reaction isn't the same. I can stay calm when she says things that are hurtful. Not all the time- it still happens but it is less often- and that is good. I found that when I don't react the same way, and I stay calm- she seems to sometimes stay calm too. It's a subtle difference, but that's a step towards something different.

Title: Re: 10 articles: Responding to Parental BPD Provocations - David M. Allen M.D.
Post by: Harri on August 09, 2017, 12:55:32 PM
Hi.  I think a lot of the message is lost when you do not read the links after each section in this post.  I clicked the first link and read the article... .it really does make a difference! 

Before having such a strong negative or even positive reaction to an article, make sure you read the whole thing.  Now, having said that, I know some people will have a negative reaction to the one link I just read.  I happen to agree with the author.

 Changing my behavior and my role in the family did, eventually, have a very positive impact on my mothers behavior and I was able to have LC.  Do I think that is possible for everyone?  No, but it is not impossible.

Title: Re: 10 articles: Responding to Parental BPD Provocations - David M. Allen M.D.
Post by: lovesherfam on August 09, 2017, 03:05:37 PM
Good article!

Title: Re: 10 articles: Responding to Parental BPD Provocations - David M. Allen M.D.
Post by: Skip on August 09, 2017, 03:12:09 PM
Hi.  I think a lot of the message is lost when you do not read the links after each section in this post.  I clicked the first link and read the article... .it really does make a difference! 

Agreed. My first read was negative and his self-proclamation of "controversial" doesn't get the reader off to a trusting start, but his message is more balanced than it initially appears and he makes some good points.

Title: Re: 10 articles: Responding to Parental BPD Provocations - David M. Allen M.D.
Post by: Skip on August 09, 2017, 05:09:15 PM
I did want to share that a little on the authors background which may help us all understand his perspective. Knowing the source is always important.

David M. Allen M.D. is a University of Tennessee professor emeritus of Psychiatry and the associate editor of the Journal of Psychotherapy Integration. My take from his background that his focus is on the dynamics of the entire family and mood and personality disorders and that he is a maverick in his field and critical of the medical state-of-the-art in handling these complex disorders and critical of the lack of focus on the family unit (all of which become involved when serious mental is present in a one family member).

According to Allen, most personality disorders are in actuality a family affair, but saying this has become politically incorrect. Political considerations can trump scientific ones in science.

He's certainly a colorful guy.

Unified Therapy
At the med school he teaches "Unified Therapy", a theory he developed which  is an integration of psychodynamic, cognitive-behavioral and family systems concepts and therapy techniques designed for the psychotherapeutic treatment of adult individuals exhibiting self-destructive or self-defeating behavior patterns. In particular, the treatment addresses the interpersonal triggers to acting-out behaviors typical of cluster B and C personality disorders. The ideas on which the integration is based are derived from dialectical philosophy and epistemology. Briefly, ambivalent role-functioning and contradictory demands in the patient's family of origin, caused by family rules which lag behind the evolution of the ambient culture, are believed to reinforce (in the behaviorist sense and on a variable intermittent reinforcement schedule) the patient's intrapsychic conflicts and the resultant dysfunctional behavior.

Here is an interview:

Date: Feb 2011(https://bpdfamily.com/book-covers/spacer.gif)Minutes: 6:41
How Dysfunctional Families Spur Mental Disorders | David M. Allen M.D.

(https://bpdfamily.com/book-covers/1568212461.jpg)(https://bpdfamily.com/book-covers/spacer.gif)Family Systems Approach to Individual Psychotherapy.
Author: David M. Allen M.D.
Publisher: Jason Aronson, Inc. (July 7, 1977)
Paperback: 392 pages
ISBN-10: 1568212461
ISBN-13: 9781568212463

(https://bpdfamily.com/book-covers/locate.png) (http://www.bookfinder.com/search/?keywords=1568212461&st=sh&ac=qr&submit=)

(https://bpdfamily.com/book-covers/0306437902.jpg)(https://bpdfamily.com/book-covers/spacer.gif)Deciphering Motivation in Psychotherapy (Critical Issues in Psychiatry)
Author: David M. Allen MD
Publisher: Plenum Press; 1 edition (March 31, 1991)
Paperback: 187 pages
ISBN-10: 0306437902
ISBN-13: 9780306437908

(https://bpdfamily.com/book-covers/locate.png) (http://www.bookfinder.com/search/?keywords=0306437902&st=sh&ac=qr&submit=)

(https://bpdfamily.com/book-covers/0805842721.jpg)(https://bpdfamily.com/book-covers/spacer.gif)Psychotherapy With Borderline Patients: An Integrated Approach
Author: David M. Allen M.D.
Publisher: Routledge; 1 edition (August 1, 2002)
Paperback: 220 pages
ISBN-10: 0805842721
ISBN-13: 9780805842722

(https://bpdfamily.com/book-covers/locate.png) (http://www.bookfinder.com/search/?keywords=0805842721&st=sh&ac=qr&submit=)

(https://bpdfamily.com/book-covers/031339265X.jpg)(https://bpdfamily.com/book-covers/spacer.gif)How Dysfunctional Families Spur Mental Disorders: A Balanced Approach to Resolve Problems and Reconcile Relationships
Author: David M. Allen M.D.
Publisher: Praeger (July 1, 2010)
Paperback: 281 pages
ISBN-10: 031339265X
ISBN-13: 9780313392658

(https://bpdfamily.com/book-covers/locate.png) (http://www.bookfinder.com/search/?keywords=031339265X&st=sh&ac=qr&submit=)

Title: Re: 10 articles: Responding to Parental BPD Provocations - David M. Allen M.D.
Post by: Notwendy on August 10, 2017, 05:06:24 AM
Hi Basenji-

Dealing with my mother is a work in progress---

I do agree with your concern over the focus on the borderline vs self needs- as for me and I think many of us- the focus of our family unit was on my mother- her moods, her needs, her feelings- walking on eggshells. We kids were disciplined- a good thing- we were taught appropriate behaviors- yet when my mother was in a rage- somehow, we were expected to pretend it didn't happen.

I also think there are degrees of trauma and abuse in families with a borderline parent. This isn't denying abuse- my mother was abusive. However, the impact of that abuse can vary. I do think there are situations where NC is the right choice- essential for the child of the borderline to have a reprieve from the abuse.

I think the impact of abusive behavior is an individual situation. None of it is good, but for me, I balance it with the situation at hand. My mother is emotionally abusive and I don't expect her to change. What has changed is how this affects me. As a child I was dependent on her, she was the one in control. Now, she is an elderly widow- and while she can say mean things to me, I am not dependent on her and I do not live with her, so I have some control over how much contact I have with her while as a child, I didn't have the choice.

I think there is power in making the choice of what kind of relationships we have. Once we make the choice, we step out of "victim" position in the dynamics. Victims have no choice and I think there are true victims- children who are abused are victims of child abuse. As adults, we can have the choice- to contact the parent or not and when we make choices, we take steps to change that.