Living With Borderline Personality Disorder – Highlights Of DBT’s Interpersonal Effectiveness Skills

Introduction To My Blog Series: Living Successfully With Borderline Personality Disorder & Histrionic Personality Disorder

I was 27 years old when I entered into the realization that there was something wrong with me and one of the original diagnosis was Borderline Personality Disorder, BPD.

I say something wrong with me because I was just not able to manage my life on my own and somehow knew there was something wrong with my mind.

Back then, not a lot was known about this horribly stigmatized disorder because BPD patients were considered impossible to treat or wrongly diagnosed with Bipolar Disorder.

Along with BPD, Post Traumatic Stress Disorder (PTSD), Attention Deficit Hyperactive Disorder (ADHD) and Dissociative Disorder Not Otherwise Specified (DDNOS) were also added to my diagnostic mix.

ADHD was quickly debunked and over the past two decades most professionals leaned towards my having PTSD or a Dissociative Disorder – but something about these disorders never seemed to fit.

Add menopause to the mix and the confusion became even more confusing.

Anxiety

Here are past blogs I’ve written about my struggles with anxiety and what felt like PTSD or DDNOS:

My Struggles With Alcoholism

Present Day

On February 9th, 2022, I had a thorough psychological assessment by a seasoned psychiatrist. At long last, at 52 years old, I was finally properly diagnosed with Borderline Personality Disorder and Histrionic Personality Disorder.

This blog series called Owning and Unraveling Borderline Personality Disorder & Histrionic Personality Disorder is my way of processing and understanding these complex personality disorders and how they manifest, interfere with and enhance my life.

Perhaps, as it has been said to me from friends who have family members with Borderline Personality Disorder, I can help dispel misconceptions and stigmas associated with these mental illnesses.

And hopefully I can shed some light and more personal information on what living with Histrionic Personality Disorder is like as I review each symptom and diagnostic criteria and how they show up (past or present) in my life.

With hope,

Stephanie, 🩵🌻

13 Week Dialectical Behaviour Therapy Group

This year I was on a long waiting list to attend a Zoom 13 Week Dialectical Behaviour Therapy (DBT) Group through Community Mental Health and Addictions (CMHA), a Nova Scotia public mental health service.

DBT was created by American psychologist Marsha Lineman, who has Borderline Personality Disorder (BPD).

Since my BPD diagnosis in 2022 I have researched and dabbled in DBT hoping it would be helpful.

Yet, I found myself overwhelmed with the extensive content of the therapy and the unlimited DBT information available on the internet.

To describe DBT as a comprehensive therapy is an understatement.

Effective, yes.

A lot of work, yes.

To be worked with and supported by a skilled therapist, absolutely.

Thankfully, after a long wait, I am currently participating in the Zoom 13 Week DBT Group, facilitated by a social worker and psychologist with CMHA.

Is 13 weeks enough?

Yes and no.

Yes, to have this opportunity.

No, because the number of specific skills taught within each section along with the in-depth weekly homework is intense!

DBT is broken down into 4 sections:

Mindfulness
Distress Tolerance
Emotional Regulation
Interpersonal Effectiveness

This DBT group is not talk therapy.

It teaches life skills.

A sorta highly advanced version of Cognitive Behavioural Therapy.

The detailed homework assigned each week allows group members to apply the skills taught to our specific BPD issues. We discuss the homework at the next group, but not in-depth. Any personal issues are directed to be discussed with our individual therapists.

According to DBT, the goals of skills training is to learn how to change your own behaviours, emotions, and thoughts that are linked to problems in living and are causing misery and distress.

One of the facilitators mentioned that DBT needs to be studied as it is taught, and I agree.

Therefore, to help me process I am going to blog about the skills taught in this group.

As mentioned, DBT is content heavy, so this blog will focus on Interpersonal Effectiveness Skills.

I am outlining the basic DBT Interpersonal Effectiveness Skills taught to us.

I certainly won’t remember all these skills, but I can come back to this blog to refresh my memory instead of getting overwhelmed when I read through the group’s DBT skills booklet.

Honestly between working the 12 Steps for my alcoholism and learning these comprehensive DBT skills for my BPD, my brain feels a bit numb. Overwhelmed with so many recovery tools.

As well, based on my own research, I realize how much DBT information is found throughout the Internet.

Perhaps this blog might be helpful for someone who sorta thinks like me.

S, 🌻

Outline – 13 Week Dialectical Behaviour Therapy Skills

Mindfulness & Distress Tolerance Skills

Emotional Regulation Skills

Interpersonal Effectiveness Skills

DBT – Skills Thermometer – A DBT Skills Anchor Chart

DBT & Interpersonal Effectiveness Skills

Goals of Interpersonal Effectiveness:

Be skillul in getting what I want and need from others
- Get others to do things you would like them to do
- Get others to take your opinions seriously
- Say no to unwanted requests effectively
Build relationships and end destructive ones
- Strengthen current relationships
  - Don’t let hurts and problems build up
  - Use relationship skills to head off problems
  - Repair relationships when needed
  - Resolve conflicts before they get overwhelming
- Find and build new relationships
- End hopeless relationships
Walk the Middle Path
- Create and maintain balance in relationships
- Balance acceptance and change in relationships
- No one is all-good or all-bad

Factors in the Way of Interpersonal Effectiveness:

I don’t have the interpersonal skills I need
I don’t know what I want
- I have the skills, but can’t decide what I really want from the other person
- I can’t figure out how to balance my needs verses the other person’s needs
  - Asking for too much verses not asking for anything
  - Saying no to everything verses giving in to everything
My emotions are getting in the way
- I have the skills but emotions (anger, fear, pride, contempt, shame, guilt) control what I do
I forget my long-term goals for short-term goals
- I put my immediate urges and wants ahead of my long-term goals
- The future vanishes from my mind
Other people are getting in my way
- I have the skills but other people get in the way (boss, health system, situations I cannot control)
- Other people are more powerful than me
- Other people may be threatened or may not like me if I get what I want
- Other people may not do what I want unless I sacrifice my self-respect, at least a little
My thoughts and beliefs are getting in the way
- Worries about negative consequences if I ask for what I want or say no to someone’s request get in the way of acting effectively
- Beliefs that I do not deserve what I want stop me in my tracks
- Beliefs that others do not deserve what they want makes me ineffective

Objectives – Obtaining Them Skillfully:

Clarifying Priorities: The Goal or The Relationship or Maintaining Self-Respect?
- How important is:
  - Getting what I want/obtaining my goal
  - Keeping the relationship
  - Maintaining self-respect
Objectives Effectiveness: DEAR MAN
- Be effective in asserting my rights and wishes
- Check my motives – Am I caring only for my self and my own needs
Relationship Effectiveness: GIVE
- Middle Path – Acting in such a way that I maintain positive relationships and that others feel good about themselves and about me
Self-Respect Effectiveness: FAST
- Act in such a way that I keep my self-respect
Factors to Consider:
- Decide how firm or how intense I want to be in asking for something or saying no

Clarifying Goals In Interpersonal Situations:

Objectives Effectiveness: Getting What You Want From Another Person
- Obtaining my legitimate rights
- Getting another person to do something I want that person to do
- Saying no to an unwanted or unreasonable request
- Resolving an interpersonal conflict
- Getting my opinion or point of view taken seriously
  - Questions:
    - What specific result or changes do I want from this interaction?
    - What do I have to do to get the results? Will it work?
Relationship Effectiveness: Keeping And Improving The Relationship
- Acting in such a way that the other person keeps liking and respecting you
- Balancing immediate goals with the good of the long-term relationship
- Maintaining relationships that matter to me
- Be authentic
- Let the other person go first – let them talk first
  - Questions:
    - How do I want the other person to feel about me after the interaction is over (whether or not I get the results or changes I want?)
    - What do I have to do to get (or keep) this relationship?
Self-Respect Effectiveness: Keeping Or Improving Self-Respect
- Respecting my own values and beliefs
- Acting in a way that makes me feel moral
- Acting in a way that makes me feel capable and effective
  - Questions:
    - How do I want to feel about myself after the interaction is over (whether or not I get the results or changes I want?)
    - What do I have to do to feel that way about myself? What will work?

Guidelines For Objectives Effectiveness: Getting What I Want (DEAR MAN)

D – Describe – Describe current situation – stick to the facts – do not bring up past
E – Express – Express my feelings and opinions – no “shoulds”
A – Assert – Assert by clearly asking for what I want or saying NO clearly
R – Reinforce – Reinforce with an expression of appreciation

M – Mindful (Stay) – Broken record technique to stay in the moment and not get hooked
A – Appear Confident – Appear effective and competent – Cope ahead to boost confidence
N – Negotiate – Be willing to give to get – maybe this can be talked about

Guidelines For Relationship Effectiveness: Keeping The Relationship (GIVE)

G – Be Nice and respectful
- No attacks
- No threats
- No judging
- No sneering
I – Act Interested – Listen and appear interested in the other person
- Active listrening
- Be sensitive to the person’s wish to have the discussion at a later time
- Be patient
V – Validate with Words and Actions
- Show that I understand the other person’s feelings and thoughts
- See the world from their point of view
E – Use an Easy Manner – use a little humor
- Smile
- Put the other person at ease
- Leave attitude at the door

Guidelines For Self-Respect Effectiveness: Keeping Respect For Yourself (FAST)

F – Be Fair – Be fair to yourself and the other person
- Remember to validate my own feelings and wishes, as well as the other person’s
A – No Apologies – Don’t over apologize
- No apologizing for being alive or for making a request at all
- No apologizing for having an opinion, for disagreeing
- No looking ashamed with eyes down and body slumped
- No invalidating the valid
S – Stick to My Own Values
- Don’t sell out my values or integrity for reasons that aren’t very important
- Be clear on what I believe is the moral or valued way of thinking and acting
- Stick to my guns
T – Be Truthful
- Don’t lie
- Don’t act helpless when I am not
- Don’t exaggerate or make up excuses
- Be clear on what I can do and cannot do

Troubleshooting: When What You Are Doing Isn’t Working:

Do I have the skills I need? Check the instructions.
Do I really know what I want in this interaction?
Are short-term goals getting in the way of long-term goals?
Are my emotions getting in the way of using my skills?
Are worries, assumptions, and myths getting in my way?
Is the environment more powerful than my skills?

Evaluating Options For Whether Or How Intensely To Ask For Something Or Say No:

Factors To Consider When Deciding How Firm Or Intense I Want To Be When Asking Or Saying No:

The other person’s or my own capability.
My priorities (Goals, Relationship, Self-Respect).
The effect of my actions on my self-respect.
My or the other’s moral or legal rights in the situation.
My authority over the other person (or their authority over me).
The type of relationship I have with the person.
The effect of my action (asking or saying no) on long – verses – short-term goals (keeping the peace in the moment – be careful of resentments).
The degree of give and take in my relationship.
Whether I have done my homework to prepare.
The timing of my request or refusal.

no writing on beach — Photo by Karolina Kaboompics on Pexels.co

Quick Links To The Blogs In This Series Living Successfully With BPD & HPD:

Borderline Personality Disorder

Forget Everything I’ve Said – I’ve Borderline Personality Disorder & Histrionic Personality Disorder

Living With Borderline Personality Disorder – Introduction to Symptoms & Causes

Living With Borderline Personality Disorder & Histrionic Personality Disorder – Rambling Through Confusion Towards Clarity

Living With Borderline Personality Disorder – Bits On Biosocial Theory & Learning To Ride Out Intense Emotions Rather Than Focusing On Why I Am Having Them

Living With Borderline Personality Disorder – Strong Opinions & Identity Crisis

Living With Borderline Personality Disorder – Not PTSD – It’s Emotions – Borderline Style

Living With Borderline Personality Disorder – Empathic Abilities & Intentional Interventions

Living With Borderline Personality Disorder – Overlapping Symptoms & What Type Of & How BPD Am I?

Living With Borderline Personality Disorder – DBT’s Mindful Breathing & Participating With Awareness – Grounding Words

Living With Borderline Personality Disorder & Histrionic Personality Disorder – The Stigma & Social Pariah Of Personality Disorders

Living With Borderline Personality Disorder – Is This Effective & Willing Hands Half Smile & The Middle Path

Living With Borderline Personality Disorder – Starting EMDR – Creating New Pathways To Calm

Living With Borderline Personality Disorder – The Pros and Cons of Medical THC & CBD

Living With Borderline Personality Disorder & HistrionicPersonality Disorder – Amber Heard VS Johnny Depp

Living With Borderline Personality Disorder – Gratitude For A Wild & Crazy Life

Living With Borderline Personality Disorder – Anxious – Ambivalent (Preoccupied) Attachment Style & Fear of Abandonment

Living With Borderline Personality Disorder – Behind My Mona Lisa Smile – What BPD Feels Like For Me

Living With Borderline Personality Disorder – The Hulk Uses Dialectical Behaviour Therapy

Living With Borderline Personality Disorder – DBT Skills Need Time & Everyday Practice To Become A Part Of Me

Living With Borderline Personality Disorder – Coping With The Inner Critic

Living With Borderline Personality Disorder – Unstable & Fragile Identities

Living With Borderline Personality Disorder – Highlights Of DBT’s Mindfulness & Distress Tolerance Skills

Living With Borderline Personality Disorder – Highlights Of DBT’s Emotional Regulation Skills

Living With Borderline Personality Disorder – My Ability To Self-Validate Grows When I Live In Alignment With My Values

Living With Borderline Personality Disorder – Highlights Of DBT’s Interpersonal Effectiveness Skills

Living With Borderline Personally Disorder – DBT – Skills Thermometer – A DBT Skills Anchor Chart

Histrionic Personality Disorder

Living With Histrionic Personality Disorder – Introduction & Symptoms & Diagnostic Criteria

Living With Histrionic Personality Disorder – Shallow, Changeable Emotions

Living With Histrionic Personality Disorder – Assumed Intimacy With Others

Living With Histrionic Personality Disorder – Hypersensitivity To Criticism

Living With Histrionic Personality Disorder – Manipulative Behaviour

Living With Histrionic Personality Disorder – Sexually Provocative Behaviour

Living With Histrionic Personality Disorder – A Compulsive Desire For Attention

Living With Histrionic Personality Disorder – Preoccupation With Appearance

Living With Histrionic Personality Disorder – Suggestible & Easily Influenced

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