How not to reinforce

[loveandcare]

I read the quote of the day on the book review page: "Reinforce the right behavior. And equally important, do not reward bad behavior. We often do". I am wondering how we reinforce... .I know that sounds like a dumb question, but what do we do as parents that contributes or exacerbates the problem? I'm thinking for me I just feel so much love and so, so sad to see my DD in so much distress, that maybe I feel "too" sorry for her, if there is such a thing... .it is so hard to get the balance between being loving and caring and compounding the problem. For example, when she cam home from hospital I just wanted to nurture and care for her, but of course too much of that and she will think "oh, if I go to hospital I get special treatment at home when I get out"... .but if I am not nurturing/loving enough she feels I am cold shouldering her (I'm not, she just perceives it that way)... .UGH!

Any ideas?

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[raytamtay3]

Great question! Something I struggle with constantly as well.  I think it comes down to establishing and sticking to boundaries personally. Something I'm working on.

[lever.]

I don't think this is about withdrawing love but it is about standing back and thinking carefully about how we respond to behavior.

For example if we show most warmth and love just after an overdose but don't recognize when someone is struggling at other times the likelihood is that the self-harm will increase.

I had to go against my instinct for a while and be very cool about self harm and it did decrease-but of course I had to offset this with a lot of warmth and support at other times.

Another way of re-enforcing unwanted behavior is by giving in to rages and not having clear boundaries (an area where I was falling down badly).

I think DBT therapists are trained to show warmth and validation for effective use of DBT skills but to show much less interest in unskillful behaviour and also to notice the tiniest effort at using the skills.

Often there is a natural inclination to give most attention to behavior we would like to see less of and which is not helpful to our children. I think the main thing is to be aware of that.

[loveandcare]

Those are great points, and something I and my DH need to work on. I would love to hear some more solid examples too... .or any resources where I can work on my own responses/actions to help her.

Thanks so much! 

[mmomm]

These examples and discussion are very valuable, please continue!  I have been trying to "catch" my son making good choices so that I can deliberately reinforce them, even if it's a small event-rewarded with warmth, a friendly acknowledgement, or a thumbs up!

[SeaSprite]

Great question! 

And you know what that means, the question is better than the answer you will receive. 

So there are some things I'm good at (usually) reinforcing the right things, primarily social norms/manners. For example, if my kids were mouthing off to me, I'd tell them to keep a civil tongue, or to try again, or I'd walk away (or send them away) and say we'll talk about it when they can be decent. In my more sarcastic moments, I would tell them that I invented smart mouthed teenager, and I wasn't going to take it from my kids.

My nonBPD d20 seemed to take these comments the way they were intended, and is developing into a young woman with good communication and conflict resolution skills, in spite of the ADHD/anxiety/depression that gallops through our family. (She takes antidepressants and has anxiety meds for acute attacks, it has helped her a lot as well)

And, my d16 went the other way, and took my admonitions to be polite and developed what I'm guessing is the quiet form of BPD- I actually welcome the brief and infrequent verbal battles we get into, because she goes underground with her problems, cutting, acting out sexually, etc behind our backs, sneaking, lying, with suicidal periods when it all starts to crash in on her.

So how to reinforce positive life choices and honesty? I have no idea, and am looking forward to following this thread.

[lever.]

I think that its important to reinforce positive behavior as well as not reinforcing unhelpful behavior.

So to try to respond with a lot of attention and help when a difficulty is raised without loss of temper and raging.

To notice when someone is unhappy but doesn't dysregulate and give a bit of care and attention but to go very cool on scraming shouting swearing etc.

I'm trying to think of DBT skills-an example would be if someone tries to raise an issue with you by saying "I was unhappy about xxx" abut doesn't yell or insult you-this would be given a lot of attention and consideration.

Also-" I feel very upset, I feel like killing myself" would get attention but cutting arms would get a cooler reception and focus more on "What was it that upset you so much?" rather than the self harm itself.

I'm just trying to think this through-may not be getting it right.

[pessim-optimist]

lever has some very good and valid points!

Also, when times get tough, and we struggle from emergency to emergency, we can get over-focused on preventing the unwanted behaviors, and then rest and take our down times when nothing is going on. That lack of attention in times that are simply ok (not exceptionally good or bad) can negatively affect our child - create a "need" for drama or another emergency in order to get the attention they are not getting at the moment.

So, it takes a lot of energy to change that dynamic to start. But in the long-run, it's worth it.

Here are a couple of workshops that are related to the topic that might also help:

BPD BEHAVIORS: Extinction Bursts

Reinforcing good behavior, positive reinforcement

[loveandcare]

Often our DD wants to be alone when she's home. Any effort to engage with her is met with sullen silence or abuse and rolled eyes. If we do manage to get her to the dinner table it is sulking and picking at food. In other words, our together times where something positive is going on are rare, but you are right - even in those small snippets of time I will have to be looking for something to praise, otherwise her only attention is during these periods of intense drama.

[loveandcare]

Perhaps slightly off topic, but I have been reading about DBT and that lead to reading about the lady who developed the system and her theories behind what causes BPD. I was saddened to read that while genetics play a part, that (according to her) an invalidating environment. In other words, as parents (she suggests) we have reinforced this behavior from birth.

Here's a snippet from that webpage:

Dialectical Behavior Therapy is based on a bio-social theory of borderline personality disorder. Linehan hypothesizes that the disorder is a consequence of an emotionally vulnerable individual growing up within a particular set of environmental circumstances which she refers to as the Invalidating Environment.

An emotionally vulnerable person is someone whose autonomic nervous system reacts excessively to relatively low levels of stress and takes longer than normal to return to baseline once the stress is removed. It is proposed that this is the consequence of a biological diathesis.

The term Invalidating Environment refers essentially to a situation in which the personal experiences and responses of the growing child are disqualified or “invalidated” by the significant others in her life. The child’s personal communications are not accepted as an accurate indication of her true feelings and it is implied that, if they were accurate, then such feelings would not be a valid response to circumstances. Furthermore, an Invalidating Environment is characterized by a tendency to place a high value on self-control and self-reliance. Possible difficulties in these areas are not acknowledged and it is implied that problem solving should be easy given proper motivation. Any failure on the part of the child to perform to the expected standard is therefore ascribed to lack of motivation or some other negative characteristic of her character. (The feminine pronoun will be used throughout this paper when referring to the patient since the majority of BPD patients are female and Linehan’s work has focused on this subgroup).

Linehan suggests that an emotionally vulnerable child can be expected to experience particular problems in such an environment. She will neither have the opportunity accurately to label and understand her feelings nor will she learn to trust her own responses to events. Neither is she helped to cope with situations that she may find difficult or stressful, since such problems are not acknowledged. It may be expected then that she will look to other people for indications of how she should be feeling and to solve her problems for her. However, it is in the nature of such an environment that the demands that she is allowed to make on others will tend to be severely restricted. The child’s behavior may then oscillate between opposite poles of emotional inhibition in an attempt to gain acceptance and extreme displays of emotion in order to have her feelings acknowledged. Erratic response to this pattern of behavior by those in the environment may then create a situation of intermittent reinforcement resulting in the behavior pattern becoming persistent.

So I am feeling pretty lousy that we may have inadvertently contributed to this  :'(

[lever.]

Loveandcare

I think the key word is inadvertently or unintentionally.

Valerie Porr's book "Overcoming Borderline Personality Disorder" has some good insights into this.

We have been parenting children with specialized emotional needs.

She makes an analogy to a child with a milk allergy.

Milk is usually good for babies-you give the milk-the child fails to thrive-you are advised to give more milk-the child gets ill.

Finally milk allergy is diagnosed-milk is NOT good for this particular child.

In the same way we can be advised to manage behavior in a certain way because it works for most children but it is not effective for our BPD child and makes things worse-however we were doing what we thought was right.

The BPD child's need for validation can be different to other children.

It is no use beating ourselves up about anything we have already tried that didn't work. We can only read, learn and try out new things.

Also check out ":)id I cause this?" at the right hand side of the board.

Valerie Porr's book is really very good and addresses a lot of these questions-I keep going back to it over and over.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[jellibeans]

I just wanted to throw in my 2 cents here... .I recently took a DBT course with my dd17 and it was very helpful. When it came to validating I realize it is not always what I say but sometimes what I don't say. Sometime my dd can be extremely emotional and have a meltdown... .I didn't realize that by walking away and trying to end our conversation was really a very invalidating thing to do. I know at times we are going in circles and she is getting more upset my the minute it is sometime hard to stay in that moment... .I have felt that I needed to retreat and let things cool off BUT what I realize is the my dd doesn't feel like she has been heard. I try now to listen and let her talk more... .instead of joining her in that emotional turmoil... .I have often taken the opposite reaction and got calm and quiet. I find that things are able to resolve themselves better if we can go through these meltdowns together. It is probably true that my dd is a little frightened by her own emotions too.

Porr's book is excellent at explaining DBT... .I read this book weekly.

One other thing I wanted to add was about the many visit to the ER. My dd at one time was going to the ER monthy... .one crisis after another. I am not sure what broke this pattern but I do beleive it is a pattern and they cycle through over and over again. It is believed by some that you should not even take your kid to the ER unless they are in need of medical help. The last time I went to the ER with my dd... .I checked her in and waited to talk to social worker then I went home. I usually would have stayed by her bed side but I really feel it is best not to reenforce this behavior in any way.

Love reading this thread... .so helpful... .loveandcare... .don't beat yourself up over what part you played in your dd development of BPD... .we are all doing the best we can... .I also believe that when my dd knows better she will do better. Baby steps... .but she will get there and so will we all.

[loveandcare]

I am definately adding Poor's book to my reading list... I have about 5 now that I will be checking out from the library!

Our DD is currently in hospital, and I try very hard to keep all the advice in mind when we visit. For example, despite having been there for 5 days, she is still puzzled and does not "get" why she is in there (she is in for trying to hang herself). My DH and I didn't find out about it until a few days later and since we had an appointment with the psych I decided best go there and see what she thought. WHen she was asked to rate her mood/feelings on a scale of 1-10, woth 10 being great, she said 2 or 3 and then said "I want to die"... .of course the psych refered her to hospital immediately.

So, during visitation, she brought up this particular psych, "She's useless and mean... .why did she put me in here? Why am I even here?"... .

Here's what I said, and I am hoping this was following SET and not in any way reinforcing things:

":)ada and I want to help you any way we can. It must feel very frustrating to be in here, especially if you don't really understand why, but the truth is that because you tried to hang yourself andbecause you told the psychiatrist you wanted to die, then hospital is the safest place for you right now".

Is this the correct use of SET? I am so new to all this, and in fact she only has a tentative DX of BPD so I am clutching at straws anyway!

[loveandcare]

p.s. thanks for the reasssurance

[HealingSpirit]

":)ada and I want to help you any way we can. It must feel very frustrating to be in here, especially if you don't really understand why, but the truth is that because you tried to hang yourself and because you told the psychiatrist you wanted to die, then hospital is the safest place for you right now".

Is this the correct use of SET? I am so new to all this, and in fact she only has a tentative DX of BPD so I am clutching at straws anyway!

That sounds exactly right to me! At least that's what I would have said to her, with SET in mind. How did she respond when you said that to her?

I think it is common for docs to give a tentative, unofficial dx of BPD to minors. This is really sad to me! I just finished reading Dr. Blaise Aguirre's book, "BPD in Adolescents." He says delaying dx is unwarranted because in the few studies they have done on adolescents presenting with symptoms in their early teens, the majority of young adults from those studies were dx with BPD. The real tragedy is that DBT intervention as early as possible has helped many BPD teens recover sooner than those who did not get DBT.

I'm so sorry your DD is in the hospital! I hope they are able to help her feel better.

Hang in there.

[SeaSprite]

The description you gave from your reading loveandcare really hits a nerve.

My d20 looked like a high risk kid but seems to be growing into an emotionally intelligent young woman. Fairly self aware, with decent communication skills.

My d16, who looked like a normal thriving kid until three years ago, is a mess. And I would have thought I was a better parent to d16, I was more patient, more experienced, and she came into the work with fewer challenges.

But it is d16 who feels invalidated, unable to express or experience emotions in a healthy way.

Somehow I managed to mess it up.

Ugh.

And, I agree with healingspirit, the way you explained things to your dd sounded very loving and honest. 

[jellibeans]

loveandcare

I think you said it wonderfully... .it is so odd that your dd doesn't understand why she is there. How is she doing today and what have they told you? hang in there

[HealingSpirit]

I wanted to respond to the "How not to reinforce" idea.  Just yesterday, I hit a new low in dealing with my DD17 and I realized I have been reinforcing the wrong things for a long time.

I'm not beating myself up about this, it was just one of those light bulb moments.

It is really hard not to respond to my DD's drama because when DH and I ignore or give minimal attention to it, she ups the anty until it can't be ignored.

We just sent her to visit her BF to reduce the stress she was having due to missing him too much. Letting her go reinforced her getting what she wants from being stressed and making life miserable for everyone. Rather than being thankful, she was ranting the second she got home about her phone not charging. So DH took her straight from the airport to the Sprint store to try to get her phone fixed/replaced. THAT reinforced her angry ranting about that.

She was still ranting when they got home because Sprint didn't fix her phone. I knew better than to interrupt the angry rant to say, "Hi, (HUG) and I missed you."  So I listened with SET, then quietly went back upstairs to finish my nap. After several minutes, she was angry because I didn't greet her properly. So, I came downstairs to give her a hug and some attention, which again, reinforced that her anger and drama works. Only she would not accept my hug or attention because she "shouldn't have to ask!" 

Sometimes the reinforcement comes from others. Today, she woke up with an upper back muscle spasm. I gave her an ice pack before I left for work and told her to alternate hot packs with cold packs until she could get in to see the chiropractor. So one of her friends just called me asking if he should take her to the chiropractor or to the hospital.  Her friends all buy into her physical pain being an absolute emergency. 

When she got bitten by our neighbor's dogs back in May, I met her at the E.R.---along with DH... .her BF (who hadn't lost his job yet) ... .and 2 of her friends who left college to be there for her.  Dh and I had to ask them to wait outside the E.R. Exam room.  I did NOT want to give so much attention to the situation, but it happened anyway because her friends buy into the "dire" nature of everything that happens to her.

I was trying to think of a way to tell her "From now on, I will give little or no attention to drama, but I will be available for positive attention." The problem is, I feel so used up lately, I don't WANT to give her attention. I don't enjoy her company and I don't want to be around her.  So, I don't think I'm capable of reinforcing the positive until I can be more positive towards her. I've mainly been trying to stay out of her way and "under the radar" for weeks. 

I guess I've given up at this point because even if I were perfect at reinforcing positive behavior, and ignoring the negative, there are so many others in her life (including DH) who continue to reinforce the drama, I don't think I stand a chance at effecting change by myself.

But,  I do see how we have reinforced her being the way she is.  Too little too late. Oh well.

[SeaSprite]

Oh healingspirit, you have said before you think we sometimes have the same daughter.

Our daughter elicits similar reinforcements, has since she was little, from her dad, from peers, even from me and I Know Better.

And, the reinforcements go both ways.

My d is pleasant when happy. And pitiful or awful when unhappy. So, we all like to help her be happy, that's what you do with people you love.

And... .then when the pursuit of happiness developes into a bottomless pit, when their emotional filters magnify negative feedback and negate the positive, all the interactions spiral downward.

There are strategies that help... .but they are exhausting and the amount of backsliding we see with what should be a minor parenting mistake is so discouraging.

It isn't fair at all how much my mood is dependant on how things are with my d from one minute to the next. It's not healthy.

Some days, I use the strategy my dad used when caring for my sick mother, allowing myself a shot of whisky, for medicinal purposes. Even doctors say one drink a day is safe for most women. 

From everything you've posted here, you sound like a conscientious and caring parent. And there is nothing wrong (or at least I hope not, because I find it helpful!) with laying low and getting some physical and emotional space.

And... .when there isn't much to reward, life can get pretty grim. It makes sense to try to provide help and joy. They just don't have the skill of appreciation yet. I wonder how to help them with that?

[pessim-optimist]

Letting her go reinforced her getting what she wants from being stressed and making life miserable for everyone. Rather than being thankful, she was ranting the second she got home about her phone not charging. So DH took her straight from the airport to the Sprint store to try to get her phone fixed/replaced. THAT reinforced her angry ranting about that.

Those are some profound observations about rewarding undesirable behavior and thus reinforcing it!

I was trying to think of a way to tell her "From now on, I will give little or no attention to drama, but I will be available for positive attention." The problem is, I feel so used up lately, I don't WANT to give her attention.  ... .I've mainly been trying to stay out of her way and "under the radar" for weeks.

That's understandable - if you're used up, you have little to give. Time to diligently schedule regular self-care to re-charge.

It is really hard not to respond to my DD's drama because when DH and I ignore or give minimal attention to it, she ups the anty until it can't be ignored.

When you find yourself alert and having the necessary energy, you might even take it to the next level: use SET early on, before it spirals out, and give your dd a choice: a chance to deescalate with the promise to help, or continue w/drama resulting in no help.

":)D, I hear you, it must be frustrating to land and not be able to talk to bf. If you can try and stay calm, I'll drive you over to the store to have it fixed."

":)D, I am so sorry you had such a frustrating trip home. Let's start over, I'd love to help you feel better, what can we do together to make that happen?"

She cooperates --> results in positive interaction. She flips --> results in either one last chance to control herself, or no help.

"I really want to help you with your phone, and I will do it as long as you can stay calm."

"Honey, I am trying to help and it isn't working. We can talk later, when you feel better."

I guess I've given up at this point because even if I were perfect at reinforcing positive behavior, and ignoring the negative, there are so many others in her life (including DH) who continue to reinforce the drama, I don't think I stand a chance at effecting change by myself.

That's the pesky intermittent reinforcement: when there is sometimes a reward for bad behavior, it makes it almost impossible to eradicate. And it takes constant effort and only some success.

It works that way even with 'regular' kids: One of SD's kids is a picky eater, skillfully manipulating for treats after (or rather instead of) meals. Years ago, I watched the kids several nights almost in a row, and I said: 'you can have a little treat, if you eat dinner.' First night: didn't eat, wanted a treat (got none). Second night: picked at food, needed reminder (treat only if eats), ate, got a little treat. Third night: ate w/out a problem, got a treat. 

I mean, this was an experiment on my part, and I was floored. This was a kid who ALWAYS picked at his food... .Two nights later, under his parents' supervision, was picking at his food again.

He knew the drill with me though, and even though he tried again and I had to put in extra effort, it was a bit easier the next time.

[lever.]

Yes -the pesky intermittent re-inforcement-so easy to fall into and such a dangerous trap. I've done it myself many times.

DD -(late evening) I need a lift to my friends house

Mom-Its too late now etc

DD -please its very important-reasons given-drama

Mom- well better to sleep on it etc,too late now

DD - crying, tears, begging, "I have no friends etc"

Mom -okay I'll run you round there but half an hour only.

What have I taught-to keep going and make a fuss next time-perhaps to even escalate to suicide threats if needed.

It sounds so silly written down that you wouldn't think any parent would do this-but in my time I have.

Animal experiments have shown that if the animal doesn't know when the pay off is coming it will keep on and on trying for hours.

I have read that intermittent reinforcement is the strongest way to encourage a behavior

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[SeaSprite]

What have I taught-to keep going and make a fuss next time-perhaps to even escalate to suicide threats if needed.

It sounds so silly written down that you wouldn't think any parent would do this-but in my time I have.

Animal experiments have shown that if the animal doesn't know when the pay off is coming it will keep on and on trying for hours.

I have read that intermittent reinforcement is the strongest way to encourage a behavior

Me too.   And this is one of those things where I Know Better... .through my educational background not to mention all of the parenting and even dog training classes I've been in.

It's why people will sit at a slot machine putting in coins, waiting for the cherries or whatever to line up.

A great example of WHY this works was given to me in some class I was in:

Imagine two neighbors. One drives a brand new Honda Civic, the other a car built sometime in the late 70's. The Honda owner comes out every morning, gets into her car, turns the key and it starts. The owner with the old beater comes out every morning, turns the key several times, and the car eventually starts.

On the morning that they both have a dead battery, who will sit there longer turning the key before they give up and call AAA for a jump start? 

But, I try not to be too hard on myself about this, and it helps that I have 2 d's, one with and one without BPD symptoms. non d 20 will ask for what she wants, and she might try again later, renegotiate, give me different information that might change my mind, etc. And with different information, sure, I'll change my answer. And she does live with anxiety and depression, so she's had times where she just can't get out of bed and go take on her day. But, she doesn't go self-destructive/lying/raging etc.

D16 w BPD- well, we all know. 

They also reinforce US, which is the hardest bit for me to recognize and overcome. I find myself making choices not based on trying to avoid triggering a cutting/suicidal/self-destructive episode, instead of more normal parenting decisions. 

I am so glad to have found this board, "normal" parents just don't know.   

[jellibeans]

seasprite

I like what you said about making decisons and how sometimes we make decisons because we want to aviod the raging and drama. This is the hardest thing for me and I don't always know when I am doing it. Recently my dd had her drivers license stolen and my husband and i really tried to make it her problem instead of ours... .even though it might have been easiler to move in and fix everything. I did get to go with her to the DMV... just one of my perks of being a parent... .

[pessim-optimist]

I like what you said about making decisons and how sometimes we make decisons because we want to aviod the raging and drama. This is the hardest thing for me and I don't always know when I am doing it.

All of training requires us investing consistent effort and putting in energy in the beginning (the payoff comes at the end). When we train a puppy or a healthy child, it is easy to keep the goal in sight, as long as we have enough energy to go around. The payoffs come soon enough.

With our BPD child it may take much more sustained effort.

Plus, being stressed out, worried, and worn out are all factors that might undermine our consistency - resulting in intermittent reinforcement. That's the biggest risk factor.

[sharklover]

If my dd18 continues to manipulatively gesture self harm, do I keep taking IVC papers out when she refuses to do any follow up treatment?

[pessim-optimist]

If my dd18 continues to manipulatively gesture self harm, do I keep taking IVC papers out when she refuses to do any follow up treatment?

Tell us more about the situation:

It probably depends on the bigger context (mainly how safe/unsafe she has been)... .What have you done in the past? Has it worked? Is this part of an escalating pattern?

What happens if you take the papers out and she calls your bluff (if it is a bluff - maybe I am assuming here)?

[HealingSpirit]

If my dd18 continues to manipulatively gesture self harm, do I keep taking IVC papers out when she refuses to do any follow up treatment?

Hello Sharklover, 

My DD17 cuts too.  And she just told me she intentionally overused RX and over-the-counter meds several times over the past couple of years that probably contributed to her recent history of digestive problems... .if her stories are true. Have you read "Overcoming BPD" by Valerie Porr?  If not, please get yourself a copy and start reading it ASAP.  I'm learning that self-harming behaviors are NOT about manipulating us, even though we feel manipulated.  They self-harm to end the downward spiral of emotional pain they are in. 

What are IVC papers?  Sorry I can't advise you about that.  But, there are things you can do to make things better by not making things worse.  Check out the Tools to the right of this board.  Validation works wonders at de-escalating a rage.  It might even stop a self-harm attack if you're lucky enough to know when it is happening. My DD always cuts in private, so we never know until after.

I know what you're going through!   

[pessim-optimist]

What are IVC papers?

Involuntary Commitment papers