1.15 | Communicate - Listen and Be Heard

[Skip]

Many of us have experienced great frustrations when trying to communicate with a BPD mother, child, friend, partner.  It's been long established that individuals with BPD can become so consumed by their own emotions/self interests that communications become challenged, confused, interpreted in the worst way.  26 years ago, Jerold J. Kreisman, MD, published S.E.T. - a communication tool to aid non-BP's in breaking through at some level.  Other tools followed, such as the DBT " D.E.A.R.M.A.N." in 1993 (Marsh Linehan, MD) and P.U.V.A.S. in 1998 (Paul Mason, Randi Kreger).  These tools are summarized below.
 
The idea behind all these tools is that a BPD has to have trust reinforced and fears of inadequacy soothed before they can listen or hear.  The non-BP validates that the feelings are real feelings (not that they are justified).  The non-BP then shifts the discussion to what the real issue is and what can be done about it.
 
These tools put a lot of responsibility of the non-BP to bridge the communication/emotional inadequacy.  The assumption is that that non-BP is the emotional caretaker in these situations.
 
These tools are more complex to use than they appear at first - especially in the emotional times that they are most needed. The thought for this workshop is to discuss the use, utility, and risks of using these and other communication tools:
 
• What works?  What doesn't?  What are traps to avoid?
 
• Has this been effective?  What positive/negative/neutral affects has it had?
 
• Do you need to be the emotional caretaker?  Is this just giving the BPD what they want?
 
• How do you keep from damaging yourself in the process? What kind of life is this?
 
• Can this done with compromising the non-BPs principles?
 
Skippy
S.E.T.- Jerold J. Kreisman, MD published SET (support, empathy, truth) in I Hate You, Don't Leave Me in 1991.  
 
When first learning S.E.T., it can seem that you are being asked to agree with the person with BPD (pwBPD). It is important to clarify that validating feelings does not mean that you agree with them, only that you recognize that the pwBPD is feeling them. It does not mean that you are letting the pwBPD off the hook, instead you are focusing on honest communication and ensuring that you are being heard, not just reacting to and defending against what is being said.
 
• S= Support refers to an initial statement which indicates the loved one supports the person with borderline personality disorder. It is a statement that begins with "I" and demonstrates concern and a desire to help. The support statement is meant to reassure the BP that the relationship is a safe one, and that her needs matter even during this difficult moment.
 
• E= Empathy refers to communicating that the loved one understands what the pwBPD is feeling, and focuses on "you." It is not a conveyance of pity or sympathy, but instead a true awareness and validation of the feelings of the pwBPD: "I see you are angry, and I understand how you can get mad at me," "How frustrating this must be for you."  It is important not to tell the pwBPD how she is feeling, but instead put her demonstrated feelings into words. The goal is to convey a clear understanding of the uncomfortable feelings she is having and that they are OK.
 
• T= Truth refers to a realistic and honest assessment of the situation and the pwBPDs role in solving the problem. It is an objective statement that focuses on the "it" -- not on the subjective experience of the pwBPD or Non-BPD. Often the pwBPD may seem to be asking, or demanding, something impossible, not taking an active role or responsibility in resolving the issue, or even presenting you with a "no-win" situation. The truth statement is meant to clearly and honestly respond to the difficult demand or behavior of the pwBPD, while placing responsibility appropriately: "This is what I can do…," "This is what will happen…,"
More information click here
 
P.U.V.A.S. - Randi Kreger later published PUVAS in 1998 in Stop Walking on Eggshells
 
• P= Pay attention
• U= Understand fully
• V= Validate emotions
• A= Assert yourself
• S= Shift stuff where it belongs
 
D.E.A.R.M.A.N. - Marsha Linehan, MD published the DEARMAN in 1993 as part of her DBT training manual.
 
• D= Describe the current situation. Tell the person exactly what you are reacting to. Stick to the facts.
• E= Express your feelings and opinions about the situation. Assume that others cannot read your mind. Don’t expect others to know how hard it is for you to ask directly for what you want.
• A= Assert yourself by asking for what you want or by saying no clearly. Assume that others cannot read your mind. Don’t expect others to know how hard it is for you to ask directly for what you want.
• R= Reinforce the reward to the person ahead of time. Tell the person the positive effects of getting what you want or need. Help the person feel good ahead of time for doing what you want.
 
• M= Mindfully keep your focus on your objectives. Maintain your position. Don’t be distracted.
• A= Appear confident. Use a confident voice tone and physical manner; make good eye contact. No stammering, whispering, staring at the floor, retreating, saying “I’m not sure,” etc.
• N= Negotiate by being willing to give to get. Offer and ask for alternative solutions to the problem. What am I willing to “settle for” or “give up” in order to gain what I want in the situation?
More information click here

[Bumpy Road]

The tools are awesome. They are awesome if they are used the right way -to help things.

I learned to use a few basic ones in my BPD relationship before I was taught them by my T. I used them to try and soften the problems and get us on a better level and field of communication.

I also caught myself using them to "win". That was bad.

Sometimes I also noticed how she knew... .or seemed to know what i was doing... .When I used them the right way for the right reasons she would generally move forward with me. If I tried to misuse (though not always intentional) she seemed to key-in to that. That bothered me (like, how did she know... .).

[JoannaK]

An important addition to this Workshop:

Our new video on communication, focusing on SET (support, empathy, truth):



https://bpdfamily.com/bpdresources/nk_a104.htm

[united for now]

Knowing when to use them and how to know which one to use will make them more effective.

There are 3 basic goals in communicating with others

* to get what we want, we have an objective

* to keep the relationship intact 

* to keep our sense of self respect

Your overall goal determines which of these skills to use, for example:

DEARMAN is used when you have an objective , you want something specific, such as to get more sleep, to have help with the chores, or to say NO to a request. You want the other person to come away feeling good about you and not full of resentment. This preserves the relationship.

Describe - describe the current situation as it stands, without using any judgments. Just stick to the facts.

Express - express your FEELINGS and OPINIONs about the situation. Assume that your feelings aren't obvious. Use clear language to help provide a reason, trying to stay with

"I" statements, such as "I want" or "I don't want" or "I feel". Be careful to stay away from using judgmental statements, Avoid saying things like "I need" or "you should" or "I can't". These will put your BP into defense mode and they won't hear your message.

Assert - assert yourself by ASKING for what you want, or by clearly SAYING NO to a request. Don't use insinuation. Don't assume others can read your mind. Don't beat around the bush. Be direct.

Reinforce - reinforce or reward the person ahead of time by explaining the positive consequences that will  make the relationship better. If appropriate, point out the possible negative consequences of your not getting what you want. Help the person feel good ahead of time and reward them afterwards. Validate the good.

(stay) Mindful - keep your focus on YOUR OBJECTIVES. Don't allow yourself to be sidetracked by old arguments or into defending yourself. Maintain your position.

* broken record - keep repeating your message over and over and over again.

* ignore - if the other person attacks, threatens, or tries to change the subject, ignore the threats, comments, or diversion attempts. Don't respond to attacks. Ignore any distractions. Keep making your point.

Appear confident - appear effective and competent. Use a confident tone of voice and physical manner. Make good eye contact. Don't stutter or stammer or back track by saying "I'm not sure"... .Watch your body language.

Negotiate - be willing to GIVE to GET. Offer and ask for other possible suggestions and solutions to the problem. Reduce your request, while still maintaining NO, but offer something else. Focus on what will work.

* turn the tables - if you aren't getting anywhere, ask them "what do you think we should do?" "how do you think we can solve this?" "I'm not able to say YES, and you really seem to want me to. What can we do here?"

Warning:  incomplete DEARMAN is ineffective and argumentative. You need to go through ALL the steps. Don't leave any out.


GIVE is used when you are working on keeping the relationship intact.  You are sincerely working on helping make things better. This is not used to get what you want or to prove your point. In fact, those will make things worse.

(be) Gentle - Be courteous and kind in your approach.

* no attacks - verbal or physical. Express your anger directly with empathy

* no threats - don't be manipulative, no hidden threats, tolerate a "no" to requests, try to stay in the discussion even if it gets a little painful (emotionally). If it becomes abusive towards you though, then exit gracefully by taking a time out.

* no judging - no moralizing "if you were a good person, you would", no "you should" or "you shouldn't" since they are clear judgments, and NO sarcasm

(act) Interested - really LISTEN and be interested in what the other person is saying. Try to see their point of view, opinion, or possible reason for saying NO or for their request of you. Don't interrupt, talk over or be rude. Be careful of your facial expressions and body language, that it is agreeable and honest.

Valiate - validate or ACKNOWLEDGE the other persons feelings, wants, difficulties, and opinions about the situation.

(use an) Easy manner - use a little humor to lighten the mood. Wheedle while being politically correct. Use a "soft sell" over a "hard sell" technique.

FAST is used to preserve your sense of self respect. This is your line in the sand kind of stuff. If you give in on these, you will feel awful about yourself.

(be) Fair - be fair to YOURSELF and to the OTHER person.

(no) Apologies - Don't be OVERLY apologetic. Don't apologize for being alive or for making the request at all. Don't apologize for having an opinion or for disagreeing.

Stick to your values - Stick to YOUR OWN values. Don't sell out your values or integrity for reasons that aren't important. Be clear on what you believe is the moral or valued way of thinking and acting, and "stick" to your guns.

(be) Truthful - DON'T LIE OR ACT HELPLESS when you are not. Do Not EXAGGERATE. Don't make up excuses.

[Steph]

DEARMAN

Describe Express Assert Reinforce (validate)

(stay) Mindful Appear confident Negotiate

Here is what DEARMAN looks like:

You: Honey, I need to talk about a problem with you. When can we do that?

Her: I am so busy... you dont get it. All you care about is yourself

You: I know you are busy. I see that every day. This is something that means alot to me. Its important. When can we discuss this

Her: You dont care about me

You: Honey, I care very much and even so, I am serious about this. Would you prefer talking tonight, or tomorrow evening? its important.

And keep coming back to what it is you want... with respect, but with your goal in mind... mindful of your needs, and open to negotiate what you can, but NOT abandon what it is you need... .remember to be respectful also. Stay centered, stay clear on your need and goal and open to hearing the other person, but not lose your goal.

[Wanda]

Another skill, when things are starting to heat up and you want to listen but they are starting to "rage" always use:

Honey i am willing to listen but i will when Things calm down 

important you say Things instead of  You need to calm down because that is  putting the blame on them it could just trigger them and keep the dance going.

another one

We will talk later when Things calm down or if  they are still raging make sure you leave and save yourself. if they choose to not calm down, letting them know you will return again when Things calm down avoiding the word you 

[united for now]

My recent use of this.

UBPbf enjoys playing computer games and everything is set up in our bedroom for him to play. Well, the other night he can't sleep, so he gets up and begins to play. I wake up to realize he is sitting at the desk with the desk lamp on, playing his game. I can't sleep, since it feels like a presence is re-engaging over me, even though he is quiet.

Bottom line - I get very little sleep.

So, trying to keep DEARMAN in mind, I go through and let him know the next morning that:

Because he was playing all night

I didn't sleep very well

If you want to play after 11pm, would you please take it downstairs so I can sleep



I was confident and calm while I stated this. He took it well and agreed at the time, but when I got home from work he was all upset and angry, cause I was trying to control when and where he could play... . 

I missed one step - didn't I  ?

[Steph]

Didja validate his feeling controlled later on? How did that go? Might wanna enroll him on the team for a solution first to get that N word ( negotiate) in there, rather than just announce how its gona be.

We sort of have this issue in reverse... when I wake up in the middle of the night, its sometimes hard to turn my brain off, so I put in a DVD of something lite and familiar, and it works great for me... but it generally wakes H up. So it went something like this:

He: I want you to have a goods night sleep. Its important for you and important for me. How can we solve this issue?

Me:I, too, want us both to sleep. Any ideas?

Him: I could wear earplugs and if you keep it down, I wont hear it and will go to sleep if I do wake up.

Me: That works. I could also sleep in the other room if it bugs you too much.

Him OK, fair enough. Lets try earplugs first.

Me: Ok, you got it.

This is what the skills can do for you! This could have been a real hotbed a year ago... .!

[united for now]

yep - I didn't reinforce the benefits for him in my idea ( I didn't validate him ), and it blew up in my face :P

I ended up back tracking and having to use lots of validation to help him feel understood and not cornered. I offered to negotiate with him, and we are working on alternative solutions to help BOTH of us feel we are getting what we need = win - win for both of us.

All the steps need to be followed, or it will end up being an argument.

The other person needs to see how what you want/need benefits them or the relationship... .


p.s. I just got a perscription for sleeping pills 

[Steph]

 This is such a learning process... and you next time, you will so easily remember the validation and "enrolling him on the team" thing... works so much nicer for everyone!

Are you finding it interesting, as you make the shift, at the insights you are having in your own communication? I remember when that started happening to me and a light went on and it was like... " Huh... he was right... I AM controlling. I AM righteous sounding... : etc...

Hard and good work, tho.

[Wanda]

 I can't beleive it! it actually worked, When my husband came home from his AA meeting i nicely asked if he thought about the 5 and 5:30 time to set the alarm instead of the 4 and 5. and i also did alot of validating boy did i validate how i understand how hard it is to get up and wanting to sleep in he is a very dedicated worker! but i am afraid i will keep having trouble getting up at 5:30 and i don't want to make him late... i didn't mention anything about it causing me problems with my sleep i kept that out.  and it worked!  I am so excited give my self a hug you wouldn't beleive how long i have been working on this stupid alarm clock issue...

oh and UNF THis alarm went off at 4 -4:15 then 4:30 then back to 5 -5:15 then 5:30 now that was really bad but i found a button i could push when it went off on the hour to stop the every 15 minute alarm... .that helped some... .now to work on not having this alarm going off at 5 but  only at 5:30 only one step at a time... .i didn't miss a step either in the DEar... .yea for me!

[ymistlhr]

How effective are these tools when they don't want to compromise with or for anything.  I have read somewhere that compromise to them is like death, no control they are wrong. I have tried some of these, with no effect, even a T did and didn't work, he didn't go back.

[JoannaK]

Here's another link to a pdf on communication techniques:

www.learningconnections.org/going_home/docs/dear_man_0908.pdf

[Randi Kreger]

I would like to share with you a technique from my new book, "The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells (Hazelden Publications 2008). The book does the seemingly impossible: give you a step-by-step system with five power tools that will show you just how to feel better, get unstuck, be heard, and set limits with confidence. The third power to is called, "Communicate To Be Heard." To write it, I spent three years looking at all the techniques shared here and many more. Then I developed a framework that fits all of them. It's easy to remember because you can sing it to the tune of Row Your Boat. Each line means something important, and it's roughly in order. Here it goes:Breathe, breathe, safety first,Acknowledge what you hear.Don’t defend, delay instead,Distract, defuse, or DEARFirst, taking a deeep, deeeeeeeep breath from your diaphram. You need air to calm yourself down. Next, assess the safety level for both you and your BP. Once someone with BPD is very emotionally aroused, they get to a point they can't turn back. The best thing to do is leave the situation because emotional and verbal abuse is very serious. And if your BP is the cutting, self-mutilating kind, you'll need to be conscious about that and prepare. Next comes "Acknowledge What You Hear." There are two kinds of acknowledging: verbal and nonverbal. This is from the book. Please DO NOT REPOST WITHOUT MY PERMISSION. lease ignore formatting and footnotes. From The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells (Hazelden Publications 2008) by Randi KregerAcknowledging, or more properly “empathic acknowledging,” is the most powerful communications technique in this chapter; it is similar to the term validation (page X). Lawrence J. Bookbinder coined the phrase on his Web site, “Touch Another HeartThis is an essential concept from an earlier time in the book] is covered by a cloak of invisibility. It’s hard to know what the real issue is. As you listen, be a detective. Just what is going on here? Take note of her feelings—not just the obvious ones, but the ones that might lie deeper. (In the next step, you’ll be rephrasing what the person is saying, so pay attention.)Don’t interrupt. In fact, don’t talk at all unless safety is an issue or you’re confused and need clarification. Bookbinder says, “Advising, comforting, encouraging, and other help-oriented verbalizations interfere with more than the other person’s talking because these verbalizations stem from our thinking about how to help, which interferes with an essential activity of empathic acknowledging—thinking about what the talker’s words mean to her.” (italics mine) [15]If you’re male, watch your tendency to want to jump in and solve problems. VERBAL ACKNOWLEDGEMENTAccording to validation enthusiasts Gary and Joy Lundberg, the authors of I Don’t Have to Make Everything All Better, responses should be kind, gentle, and respectful with the intent of understanding the other person.[16] For example: •   Use verbal encouragers: “Oh,” “Hmm,” “Really,” “Wow,” “That’s interesting,” “Cool,” “I see.” These responses show you’re listening.•   Reflect their feelings: “That sounds (frustrating, sad, scary, wonderful, difficult, exciting)” “I bet that was (difficult, etc.) •   Show involvement: “I’m (happy, sad, glad) for you.” “I would feel (confused, lonely happy) too.” •   Punctuate intense emotions: “I can’t believe that!” “Oh no!” “How wonderful!” “I’m so sorry that happened to you.” Asking validating questions is another form of acknowledgment. The Lundbergs say:Asking the right question is vitally important in helping someone discover the solutions to their own problems. Without these questions, they will fall back on, “What should I do?” Remember you don’t have to solve their problem. In fact, you don’t even have the power to solve it. You can help, however, by asking the kind of validating questions that will lead them to the exploration of their own feelings and desires, and to their own best solutions.�

[Randi Kreger]

Forgot to caution that this is not the whole communications technique. We got to the breathe, safetly first and acknowledge, but not all the D's.

[Randi Kreger]

How effective are these tools when they don't want to compromise with or for anything.  I have read somewhere that compromise to them is like death, no control they are wrong. I have tried some of these, with no effect, even a T did and didn't work, he didn't go back.

This is really a comment (and a good one) about boundaries rather than communication. I recently did a workshop on that: see https://bpdfamily.com/content/values-and-boundaries Randi Kreger Author, "The Essential Family Guide to Borderline Personality Disorder "

[gotbushels]

Which page is PUVAS on? Thank you.

[gotbushels]

Which page is PUVAS on? Thank you.

Okay so I was digging around SWOE again. I couldn't find PUVAS in the 2010 edition. I don't know about the 1998 edition of SWOE. For those interested, it's supposed to be in the 2002 workbook version, The Stop Walking on Eggshells Workbook: Practical Strategies for Living with Someone Who Has Borderline Personality Disorder.