Guidebook to Kashmir's Emotionally Unstable Personality

Emotionally Unstable Personality or Borderline personality disorder (BPD) is a pattern of instability in personal relationships and self-image. People with BPD have a hard time recognizing and controlling their emotions.

For both the individual with the disorder and their loved ones, dealing with this disorder can be difficult. If you or someone you care about suffers from Borderline Personality Disorder, there are certain strategies you can use to cope.

1. Pay attention to your emotions. The inability to perceive, define, and label one's emotions is a typical problem among people with BPD. Slowing down and thinking about what you're feeling during an emotional event can help you learn to control your emotions.

Throughout the day, try "checking in" with yourself many times. Take a short pause from work, for example, to close your eyes and "try to get connected" with your body and emotions. Take note of whether you are physically tense or achy. Note whether you've been thinking or feeling about anything for a long time. Keeping track of how you're feeling can help you in learning to recognize and control your emotions.

Put efforts to be as definite as possible. Instead of thinking, "I'm so angry I can't handle it!" try identifying where you believe the emotion is coming from: "I feel angry because I was late to work because I got delayed in traffic."

When you're thinking about your emotions, try not to pass judgment on them. For example, refrain from telling oneself things like "I'm angry right now. Why am I angry all the time? It is not good to be angry." Instead, focus solely on identifying the emotion without passing judgment, such as "I am angry because it was hurtful that my friend was late."

2. Determine the difference between primary and secondary emotions. Learning to identify all of the emotions you might experience in a particular situation is a crucial step toward regulation of emotions. People with BPD frequently feel overwhelmed by a whirlwind of emotions. Take a moment to distinguish between what you're feeling right now and what else you might be feeling.

Your first emotion can be anger, if your friend, for example, forgot that you were having lunch together today. This would be the primary emotion.

There's a chance that the anger is accompanied by other emotions. For example, you can be feeling hurt because your friend has forgotten about you. You may be worried that this is a sign that your friend doesn't care about you. You can feel ashamed, as if you don't deserve to be remembered by your pals. All of these feelings are secondary.
Understanding where your emotions come from can help you learn to control them.

3. Be habitual of positive self-talk. Challenge negative attitudes and patterns with positive self-talk as one approach to handle your reactions in a more healthy way. It may take some time to feel at ease doing this, but it is beneficial. Positive self-talk has been demonstrated to help you feel more alert, enhance your concentration, and reduce anxiety.

Remind yourself that you deserve respect and love. Make it a fun to look for qualities in oneself that you like, such as competency, kindness, imagination, and so on. When you find yourself feeling down about yourself, remind yourself of these good aspects.
Remind yourself that bad things happen to everyone at some point, and that they are only transitory. For example, if your coach critiqued your cricket practice performance, remind yourself that this is not typical of your performances in the past or future. Instead of dwelling on what went wrong in the past, concentrate on what you can do better next time.

This will make you feel that you can control over your actions, instead of feeling like you are being ill-treated by someone else.

Negative thoughts should be reframed in a positive light. If you didn't perform well on a test, for example, your initial thinking might be, "I'm such a loser. I'm worthless, and I'll fail this class." This isn't helpful, and it's also not fair to you. Instead, consider what you can gain from the experience: "I didn't do as well on this exam as I had planned." I can talk to my professor about my weak points and how to study more effectively for the upcoming exam.

4. Before reacting to others, take a moment to check in with yourself. Anger or despair are common reactions for people with BPD. For example, if a friend did something to make you feel sad, your immediate reaction might be to go into a rage and threaten the other him/her. Instead, spend some time getting to know yourself and identifying your emotions. Then, in a nonthreatening manner, try to explain them to the other individual.

If a friend came late for lunch, for example, your first emotion might be anger. You might want to scream at them and demand to know why they were so disrespectful to you.

Make a mental note of your emotions. How are you feeling right now? Is there a primary emotion, and if so, what are the secondary emotions? You may be feeling angry, but you may also be feeling fear since you believe the reason behind your friend’s being late because they don't care about you.

Ask the person why they were late in a calm voice, without being judgmental or without threatening them. Make statements that are "I"-centered. Consider the following scenario: "I'm feeling disappointed that you were late for our lunch. What caused you to be so late?" You'll most likely discover that your friend's tardiness was due to some reason, such as traffic or unable to find car keys. You obviously might not want to sound like you're blaming the other person, so use "I" sentences. They will feel less defensive and more open as a result of this.
You can learn to moderate your responses to other people by reminding yourself to examine your feelings and not jump to conclusions.

5. Delineate your feelings in detail. Associating physical symptoms with the emotional states in which you typically experience them is a good start. Learning to recognize your physical as well as emotional feelings might help you better articulate and comprehend your emotions.

For example, you might get a sinking sensation in the pit of your stomach in specific situations but have no idea what it means. Consider the feelings you're having the next time you have that sinking. This sinking sensation could be linked to anxiety.

Once you recognize that the sinking sensation in your stomach is anxiety, you will begin to feel more in control of the sensation rather than as if it is controlling you.

6. Learn Self-relaxing techniques. When you're in a tumultuous situation, learning self-relaxing activities might help you stay calm. These are activities you can do to comfort and treat yourself with kindness and care.

Few examples:

Take a hot shower or bath. Physical warmth has been shown to have a calming impact on many people.
Relax by listening to calming music. According to studies, listening to certain kinds of music can help you relax.
Try relaxing yourself by self-touch. By generating oxytocin, touching yourself in a loving, relaxing manner can help you relax and decrease stress. Try crossing your arms over your chest and gently squeezing yourself. Put your palm over your heart and note how your skin warms, your heart beats, and your chest rises and falls as you breathe. Take a few moments to tell yourself that you are lovely and deserving.

7. Put efforts to Increase your tolerance for ambiguity or distress. The ability to tolerate an unpleasant emotion without reacting to it inappropriately is known as emotional tolerance. This skill can be developed by being familiar with your emotions and progressively exposing yourself to novel or uncertain events in a safe atmosphere.
Throughout the day, keep a journal in which you record whenever you feel uncertain, anxious, or fearful. Make a note of the circumstance you were in when you felt this way, as well as how you dealt with it at that time.

8. Train yourself in tolerating uncertainty. Begin by putting yourself in small, safe situations. For example, at a new restaurant, you could order a meal you've never eaten before. The meal may or may not be enjoyable for you, but that isn't the point. You will have proven to yourself that you are capable of dealing with uncertainty on your own. As you gain confidence, you can gradually progress to more challenging scenarios.
Make a note of your responses. Make a note of what happens when you try anything new. What exactly did you do? How did you feel throughout the event? After that, how did you feel? What did you do if things didn't go as planned? Do you believe you'll be able to take on greater responsibilities in the future?

9. Try practicing having unpleasant experiences. Your therapist might give you activities to help you learn to cope with unpleasant feelings. The following are some things you can perform on your own:

Hold an ice cube in your hand until the negative emotion subsides. Concentrate on the feel of the ice cube in your hand. Take note of how it intensifies at first, then fades away. Emotions behave in the same way.

Consider an ocean wave. Consider how it rises till it crests and then sinks. Remind yourself that emotions build and then subside, much like waves.

10. Do some exercise on a regular basis. Exercise can help you feel less stressed, anxious, or depressed. This is because physical activity causes your body to release endorphins, which are natural "feel-good" chemicals. Even moderate activity, such as walking or gardening, has been shown to have these effects.

11. Maintain a regular schedule. Because one of the features of BPD is instability, sticking to a regular routine for things like meal times and sleep might be beneficial. BPD symptoms can be exacerbated by blood sugar fluctuations or sleep deprivation.
Ask someone to remind you if you have problems remembering to take care of yourself, such as forgetting to eat meals or not going to bed at a healthy time.

12. Keep your ambitions in check. It takes time and practice to deal with any disorder. In a few days, you won't see a complete revolution. Allowing yourself to become discouraged is a bad idea. Remember that you can only do your best, and that's enough. It's important to remember that your symptoms will improve with time, not in an overnight.

13. Consult a psychologist/therapist. For persons with BPD, therapy is one of the most important sources of help. A trained therapist's assistance and direction can make a major difference in BPD therapy and recovery. Therapy can provide a secure environment in which you can begin to work through your relationship and trust issues, as well as "try on" new coping skills.

Although there are various types of therapy that can be used to treat BPD, Dialectical Behavior Therapy, or DBT, has the best track record.

Dialectical Behavior Therapy (DBT) is a therapeutic modality designed exclusively for patients with BPD. It has a proven track record of success. DBT teaches persons with BPD how to control their emotions, improve frustration tolerance, gain mindfulness skills, identify and label their emotions, and strengthen psychosocial skills in order to engage with others.

Schema-focused therapy is another common treatment. CBT techniques are combined with strategies from other therapy modalities in this form of treatment. It focuses on assisting people with BPD in reorganizing or restructuring their views and experiences in order to help them develop a stable self-image.

14. Medical/psychiatric help:

Despite the fact that many patients with BPD take medication, there is little evidence that it is effective. Furthermore, the Food and Drug Administration (FDA) in the United States has not approved any drugs for the treatment of BPD.

This isn't to say that medicine isn't useful—especially if you have co-occurring issues like depression or anxiety—but it's not a cure for BPD per se. Therapy is far more beneficial in the case of BPD.

Your doctor may, however, prescribe medicine if:

You've been given a diagnosis of BPD as well as depression or bipolar disorder.

You suffer from extreme anxiety or have panic episodes.

You start having strange, paranoid thoughts or hallucinating.

You're having suicide thoughts or are at risk of hurting yourself or others.

  • The author is a licensed clinical psychologist (alumni of Govt. Medical College Srinagar). He works at Kashmir Life Line, a free mental health counseling service. Author can be reached at [email protected]

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