by Marcia Moitoso | Nov 23, 2021 | Connection, Counselling, Love, Mental Health, Post-Traumatic Stress Disorder, PTSD, Relationship, Relationships, Safety, Therapy, Trauma, Trauma sensitive
This article talks about some skills and strategies to heal the traumatized part of your brain and move toward the intimacy you deserve. If you missed the last article about the ways that sexual abuse/assault impacts intimacy and sexuality, I’d recommend going back and reading that article before beginning this one.
Remedies
Every nervous system is a little different. What works for one person may not work for another. There are many options for healing trauma and developing a healthy intimate and sex life, so I encourage you to choose options that resonate best with you.
Shift Ideas about Sex
A good place to start might be with the ideas you and your partner(s) hold about sex. Often survivors of sexual assault hold negative beliefs about sex. These beliefs result from parts of our brains confusing sexual assault (violence) with sex (consent, pleasure, equality). The two are not the same, and we need to rewire our brains to reflect this. I recommend having a look at Wendy Maltz’s comparisons chart here https://healthysex.com/healthy-sexuality/part-one-understanding/comparisons-chart/. This will help explain the difference between ideas about sex that come from experiences of abuse, versus healthy ideas about sex.
You can continue to develop a healthy sexual mindset by avoiding media that portrays sexual assault or sex as abuse or talking about sexual attitudes with friends or with a therapist. You can also educate yourself about sexuality and healing through books and workshops. One book I strongly recommend is Come as You Are by Emily Nagoski.
Communication with Partners
This may be the most important recommendation in this article. You cannot have consensual sex without communicating about it. That’s true for anyone, whether they’re an assault survivor or not. Sex remains a taboo subject in our culture, even though sex is very normal and most people have some form of sex at some point in their lives. When things are taboo and not widely talked about and understood, people develop feelings of shame about the taboo subject. Shame lurks in the darkness. This feeling of shame or embarrassment or even just awkwardness keeps many people from talking about sex with their partners despite engaging in sex.
Consent is dynamic: It can be given and withdrawn at any time
All people, and especially survivors of assault/abuse need to be able to give and withdraw consent AT ANY TIME during a sexual or intimate act. Many survivors will experience flashbacks or triggers at various times through physical or sexual activities. Because they don’t feel safe to tell their partner to stop (often out of fear for making them feel bad), they will instead dissociate and push through the sexual experience. When you do this, you are telling your brain and body that what you feel doesn’t matter and that the other person’s pleasure or comfort is more important.
While it may feel frustrating to have to stop mid-sex or mid-kiss or mid-hug because something has triggered you, listening to your body will actually help the healing process go much faster. Each time you override what your brain and body needs, the trauma gets reinforced and the triggers continue to come back. Slower is faster when healing from trauma. This is something partners need to understand. If a survivor is saying no, it’s because they trust you enough to say no, not because they’re not attracted to you. Every “no” is sexy because it’s getting you closer to an enthusiastic, consensual “yes”
Understand and Communicate your preferences
In addition to understanding and respecting the need to withdraw consent at any time, it’s important to talk about sexual preferences. What feels good, what feels neutral and what doesn’t feel good. Communicate when something felt uncomfortable and explore together to find what does feel comfortable. When sex is approached with curiosity and exploration rather than rigidness and shame, it becomes increasingly safe and pleasurable for both parties.
The need to take a break
Sometimes survivors of sexual abuse and assault may need to take a prolonged break from sexual activity. This can happen when the individual is in a relationship or not. The break allows space to focus on healing and figuring out what feels good and what doesn’t without worrying about the anxiety of managing their partner’s advances. When you are ready to engage in sexual activity again, do so when you want it, not when you believe you “should.” You have a right to be an active participant in your own sex life. Communicate your likes and dislikes and give yourself permission to say no at any time.
How to Manage Triggers and Flashbacks
As mentioned above, some survivors will experience triggers or flashbacks during physical touch or sexual activity. Flashbacks and triggers are often thought of as images of the traumatic experience. But they can also be experienced as unpleasant sensations, or a lack of sensation, an experience of disconnection, or an experience of overwhelm. When this happens it’s important to stop whatever is triggering the flashback, i.e. stopping the sexual activity or the physical touch. When you have a flashback, a part of your brain thinks it is in the past when the trauma happened, You need to remind that part of your brain that you are in the present moment and that the danger has passed. Another word for this is “grounding.”
Grounding Strategies/Orienting back to the present moment
- 5,4,3,2,1
- Name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, 1 you can taste
- Deep breaths
- Breathe in for 4, hold for 7, out for 8 (or any variation of that where you breathe out longer than you breathe in
- Box breaths: in for 4, hold for 4, out for 4, hold for 4 (repeat 4 times)
- Stand up and move your body – get the adrenaline out
- Run on the spot, go for a walk, jumping jacks
- Watch youtube video that makes you laugh (laughter is grounding)
- Play a categories game
- Say the alphabet backwards
- Show these strategies to your partner and do them together
Once you’ve successfully grounded (and give yourself as much time as your nervous system needs for this, remember slower is faster), take some time to rest and find comforts. Your nervous system has just gone through a lot. It can also be good to think about what triggered you and to discuss with you partner how to change that in the future. You may want the help of a counsellor to determine this.
Counselling
Trauma counselling can really help you to overcome the impacts the trauma has on your life. You may also want to incorporate some couples counselling to help improve communication so that the two of you can work as a team on this.
There are 3 types of trauma counselling that can be beneficial. You may benefit from a mix of all three.
Top-Down counselling:
This type of counselling helps you to change the thought patterns and behavioural habits that have formed as a result of the trauma. You will learn to notice the emotions and to change the behaviours and thoughts that tend to come as a result of the emotions. Some examples of this include CBT and DBT.
Bottom-Up Counselling:
Emotions and survival responses are physiological. You may notice a tightness in your chest when you feel anxious, a lump in your throat when you feel sad, a pit in your stomach when you feel embarrassed, or any variety of physical manifestations of emotions. When we feel an emotion our bodies are automatically mobilized to do something with it. For example, if you see a grizzly bear, your body might instinctively run or freeze or even try to fight it. You don’t even have to think about it, your brain does it automatically! Your body also knows how to heal from the trauma, but often circumstances prevent us from being able to allow our bodies to do what they need to do. Bottom-up counselling approaches such as EMDR, Sensorimotor Psychotherapy, or Somatic Experiencing can help you to process the trauma by mindfully allowing your body and brain to do what it needs to do to heal. This will also greatly improve your relationship to your body
Mindfulness Counselling or Practices
Through mindfulness practices you can train your nervous system (brain and body) to become fully present. You learn to notice when triggers are happening while keeping a foot in the present-moment so that you don’t become overwhelmed. With mindfulness you can learn to allow emotions to come and go naturally without being swept away. If you’d like to start mindfulness on your own I’d recommend starting with short 2 minute practices and slowly working your way up. Examples of mindfulness-based counselling include Mindfulness Based Cognitive Therapy and Mindfulness Based Stress Reduction.
I hope these tidbits can help you get started, or to continue on your healing journey. You deserve a healthy intimate life that includes boundaries, consent, pleasure and joy. Slower is faster; trauma takes time to work through, but it is very treatable, and you don’t have to do it alone.
Sources
Maltz, Wendy (2021). Healthy Sex: Promoting Healthy, Loving Sex and Intimacy. https://healthysex.com/
Nagoski, Emily (2015). Come as you Are: The Surprising New Science that will Transform your Sex Life. Simon & Schuster Inc: New York.
University of Alberta Sexual Assault Center (2019). Sexual intimacy after sexual assault or sexual abuse. https://www.ualberta.ca/media-library/ualberta/current-students/sexual-assault-centre/pdf-resources-and-handouts/intimacy-after-sexual-assault-2019.pdf
by Marcia Moitoso | Nov 16, 2021 | Connection, Counselling, Love, Mental Health, Post-Traumatic Stress Disorder, PTSD, Relationship, Relationships, Safety, Therapy, Trauma, Trauma sensitive
Note: This article speaks in broad terms about sexual assault and abuse. If you feel overwhelmed at any point reading this article, I encourage you to stop reading (or skip to the section on “grounding”) and allow your body to do what it needs to do to come back to the present. Whether it’s going for a brisk walk, doing some deep breathing, or calling a trusted friend. As this article will discuss, there’s no need to push yourself past the point of overwhelm. Healing can only take place with patience.
Many survivors of sexual assault face difficulties with intimacy and/or sexuality at some point in their lives. While this is a very common experience, it’s certainly not the case for all survivors. Traumatic events affect people in a variety of different ways dependent on each person’s life experiences and their unique nervous systems. This article will focus on the people who do struggle with sex and intimacy after traumatic events. It will show that even though it can feel really hopeless at times, there are some amazing ways forward to achieving a healthy and satisfying sex life. We have some powerful innate abilities to heal trauma, but it often takes patience, support and work to get there.
Understanding the Impacts
Sexuality and the Central Nervous System – Stress and Love
Sexuality is impacted by the emotional systems managed by a very primal part of your brain often called “the reptilian brain.” This part of your brain is responsible for stress feelings as well as love feelings, all of which have helped us to survive as a species. Stress and love are also the main emotions that impact intimacy and sexual desire.
Stress responses are the neurobiological processes that help you deal with threats. Your brain prioritizes one of the following three main components based on survival needs: fight (anger/frustration), flight (fear/anxiety), or collapse (numbness, depression, dissociation).
Love is also a survival strategy; it’s the neurobiological process that pulls us closer to our tribes and bonds humans together. Love is responsible for passion, romance, and joy. It’s also responsible for the agony of grief and heartbreak.
Common Reactions
When a person lives through a traumatic event, the stress response in their central nervous system (brain and body) often gets locked into survival mode. It has detected that there is danger and so it learns that it must always be scanning for any sign of danger. As a result, there are two very common reactions to sexual trauma that affect a survivor’s sex life.
- Sexual Avoidance/Difficulty Experiencing Pleasure
The main function of the central nervous system is to prioritize survival needs in order of importance. For example, if you can’t breathe, you’re unlikely to notice that you’re hungry until you get oxygen again. Similarly, although love is indeed a survival mechanism (bringing us together with our tribes), the brain tends to prioritize attention to stress over love because stress points to a more immediate threat: the possibility of another dangerous and violent act.
After a sexual assault, sensations, contexts and ideas that used to be interpreted as sexually relevant (like physical touch) may instead now be interpreted by your brain as threats. So sexual situations actually make your brain sound the “danger” alarm bell. Our central nervous systems confuse sex (an act of consent, equality and pleasure) with sexual assault (an act of violence and power over another). Remember, your nervous system’s primary function is to keep you alive and safe, so anything that feels in any way similar to a violent situation from the past will sound your brain’s alarm bell.
Basically, you may be experiencing love or desire, but your brain is still stuck on survival mode. This makes it almost impossible to experience pleasure, desire and closeness.
- Engaging in Compulsive Sexual Behaviours
Remember how love is also a survival strategy? It draws us closer to others and makes us feel whole. So instead of stress hitting the sexual brakes, some people get locked into patterns of feeling out of control sexually and having multiple partners. In this case, sometimes the innate survival strategy prioritizes closeness for that feeling of being whole; however, when this is a survival mechanism, it’s often happening from that “collapse” stress response, or a more dissociated place. People stuck in this pattern may experience a brief feeling of relief but may still struggle with the deeper components of intimacy.
- Additional common symptoms
- sexual avoidance/anxiety
- sex feeling like an obligation
- dissociation during sexual activity/not present
- negative feelings associated with touch
- difficulty achieving arousal/sensation
- feeling emotionally distant
- flashbacks/intrusive thoughts or images during sexual activity
- engaging in compulsive sexual behaviours
- difficulty maintaining an intimate relationship
- vaginal pain in women; erectile dysfunction in men
- feelings of shame
- negative beliefs about sex
This is a short list of reactions, there are many more impacts on a person’s sense of self and experiences in relationships. If you’d like to get a better sense of how your traumatic experiences may have impacted your sex life, you can have a look at Wendy Maltz’s Sexual Effects Inventory here https://www.havoca.org/survivors/sexuality/sexual-effects-inventory/
Remedies: Developing a Healthy Sex Life
This short article was just to give you an idea of some of the many ways that sexual assault can impact intimacy. These impacts sometimes show up directly after the assault and sometimes show up years later.
Stay tuned for the next article which will talk about some of the many ways to heal the parts of your brain that are impacted by the trauma and to help you to find safety and pleasure in intimacy.
Sources
Maltz, Wendy (2021). Healthy Sex: Promoting Healthy, Loving Sex and Intimacy. https://healthysex.com/
Nagoski, Emily (2015). Come as you Are: The Surprising New Science that will Transform your Sex Life. Simon & Schuster Inc: New York.
University of Alberta Sexual Assault Center (2019). Sexual intimacy after sexual assault or sexual abuse. https://www.ualberta.ca/media-library/ualberta/current-students/sexual-assault-centre/pdf-resources-and-handouts/intimacy-after-sexual-assault-2019.pdf
by Andrew Neufeld | Aug 2, 2018 | Communication, Connection, Relationship
Reflections on 15 years of marriage…
Today is the anniversary of the best decision I’ve ever made. This sounds cheesy, perhaps, but it also happens to be true. Fifteen years ago, I married Meg, and it’s been a wild ride ever since. Depending on how you recount history, our story either started in grade 5 or when I was 16. I went to school with her twin sister when I was in grade 5, and I remember when she came into our class for the first time to deliver a message to her sister. Now, you have to understand, I was in no way, shape, or form smooth at that age (many would argue that never changed). But, I distinctly remember turning to my friend and saying, “Wow, she could come back more often.”
Fast forward to when I was sixteen and started working at a summer camp. I walked along the boardwalk and low and behold, there was a beautiful girl that I recognized. I walked up to her and asked her, “Do I know you from somewhere?” She, thinking I was feeding her a line, literally got up and ran away. Now, I’m not using the word “literally” in the new-school hipster way, I actually mean she literally got up, moved her feet at a rapid pace, and in the opposite direction. Great start to a relationship.
Needless to say, it took a few years of work to get her to stop running away and to actually consider that I might be marriageable material. But, when I was 20 and she was 21, I asked her to marry me and, as they say, the rest is history.
As I was trying to fall asleep last night, my mind kept circling the question, over and over, “How is it that our relationship has lasted, and gotten infinitely better over time?” See, it hasn’t been easy. We got married young, and in our first year of marriage we went kamikaze with school, work, and other activities and didn’t see each other a whole lot (I definitely do not recommend this approach…). We are quite different people in many ways, and we often don’t see things the same way. And now, we’re business partners full time. Our recipe for success isn’t so simple! I also realize that we’re still in our infancy in our relationship at 15 years in – my parents will be celebrating 48 years of marriage this year, something I aspire to. So, this article isn’t definitive, because we have a long way to go!
I can’t write nearly as much as I wish I could hear, so I’ll save some for a later article. Here are three things that have been helpful to me in our marriage, and I hope will be helpful to you in your relationships.
- If you know you’re wrong, admit it. If you know you’re right, shut up.
A very close family friend wrote this on the wedding card he gave us on our wedding day. I didn’t realize that this was a quote from Ogden Nash at the time, but it’s always stuck with me. Anyone who knows me knows that I love a good argument, and I’m pretty opinionated. I don’t expect everyone to agree with me, but if we’re arguing, I’m going to try to win the argument.
This is not a recipe for success in marriage. If it’s simply an intellectual argument it might be ok. If the argument is about something you’ve done wrong, arguing that you were right is not going to help things. Similarly, if you know you’re right it may not be your best course of action to beat this over the head of your partner. Chances are they know you’re right (even if they don’t want to admit it), and forcing the issue will just breed resentment.
- Accept influence from your partner.
This one does not come naturally to me, at all. I’m not even sure why because I often say, and I sincerely believe, that I married up. It would only make perfect sense for me to accept Meg’s influence as a matter of course, but for some reason, it’s still challenging for me. There’s still a little birdie on my shoulder that, when I’m under stress, tells me that accepting influence is admitting defeat. Let me assure you, it’s not.
Accepting influence from your partner means that we shift from a focus on me and instead, focus on we in the relationship. John and Julie Gottman refer to this as the we-ness of the relationship and it’s something they measure in their research i. If you’re a research geek like me, feel free to have a read of this article that highlights how John Gottman has shown that relationships are far more successful when men accept the influence of their partner. It’s important for women to do this too, but the research seems to show that most women are already pretty good at it.
- 69% of conflict in relationships is due to perpetual problems.
This fact can either be encouraging or be discouraging depending on how you look at it. This statistic comes from John Gottman’s research and it’s been replicated. Perpetual problems are the issues that come up in the relationship over and over again. These problems are due to fundamental personality differences or lifestyle needs and are not going to be solved. These problems simply need to be managed. The conflict stems from the idea that we can change these things, rather than accepting them and managing them.
Part of me finds this frustrating. My brain and my passion drive me toward creating positive change and my superhero complex leads me to believe I can solve all of life’s problems if given enough time. When I’m stuck in this mode, I get frustrated and wonder why, after 15 years, we stumble through the same issues and I haven’t figured out how to solve them yet.
My more reasonable, rational self-finds this encouraging. I find it encouraging that after 15 years of struggling with the same issues, we still have a great marriage. We haven’t given up. We haven’t grown resentful. Somehow, even though we can’t change it, we find a way through it together. Over, and over, and over again.
We’re not perfect, even after 15 years of working at it
I didn’t want this article to come across as Andrew’s guide to having the perfect marriage that he has with his wife, and I hope it doesn’t come across that way. We’re not perfect, and we regularly screw it up. But when we do, we work hard at it.
Relationships are difficult. My marriage is by far the most difficult thing I’ve had to work on, and I can say without reservation, that I’ve had more work to do on myself than my partner has. She’s better at this than I am, she’s more of a natural, and Gottman’s research seems to support this.
What their research also shows, however, is that if I continue to work on this, and continue to accept Meg’s influence, my doing so is one of the most powerful forces to effect positive change in our relationship – and that’s what I’m going to work on for the next 50 years, God willing.
I love you Meg. Thank you for working on this with me and teaching me every day.
It’s ok to laugh at this. Every time I go to one of their training and they use this word, I laugh. Part of maturity is accepting that we laugh at immature things. Or something like that.
If you’re looking for some summer reading that will improve your relationships, check out this book by John Gottman. It’s a great primer for some of the principles that make relationships last!
by Chantelle Phillips | Apr 11, 2018 | Counselling, Emotionally Focused Therapy, Group Therapy, Relationship
With an increasingly multicultural society, it is becoming more important than ever for therapists to consider the impacts of these different cultural aspects on their clients4. Today’s couples are becoming more diverse in terms of culture, socioeconomic status, ability, ethnicity, and religion, just to name a few. This means that we as therapists to adjust our practice appropriately. In this blog, we’ll look at how therapists can support diverse couples in relationships from different religious or faith backgrounds in a therapeutic setting.
The Challenge
Interaction among different religious, cultural, and ethnic groups has been shown to be beneficial in platonic relationships when the interactions are “amicable, positive, and voluntary”, but romantic relationships may present a greater challenge. Separately, marriage has been shown to positively correlate with physical and psychological health and religion has proven to be a protective factor for many; together, marriage and religion can spur additional external stressors. Differences in religion can often mean differences in culture, tradition, and ethnicity, which has the potential to create additional stress on the relationship. These external stressors often come in the form of extended family, or society as a whole, when traditions appear altered or compromised. Research has shown that these factors can have a detrimental impact on the psychological well-being of couples with different religious backgrounds.
There are particular factors within religiously diverse couples that can tip the scales in either a more positive, or more challenging direction. First, couples vary on how strongly they use religion to define a relationship. Religion may enforce particular “rules” to determine how interpersonal or family challenges are addressed, such as sexuality, parenting, or power. Second, religiosity exists on a spectrum, so factors such as religious practice, involvement, activity, and belief intensity all contribute to potential stress in a relationship; both individuals in a relationship can even be of the same religion and differ in the strength of religious faith or religious motivation. Third, underlying values may overlap in different religions allowing couples to find common ground; for example, many religions view extramarital sex as unacceptable. Couples from different religious or faith backgrounds can be successful if differences are addressed, understood, and respected; if left unaddressed these differences can become conflictual and threaten the relationship.
How Can We Help?
From a therapeutic perspective Emotionally Focused Therapy (EFT), a form of couples counselling has shown to be effective for addressing distress in relationships. EFT believes that relationship distress stems from perpetuating negative interaction cycles, which often result from unmet needs. For example, this could be shown in how a couple manages conflict; is the conflict discussed and resolved or does an argument ensue that leaves both parties angry and resentful? The goal of EFT is to develop secure attachment through identification, experience, and expression of emotional and attachment needs. The basis of EFT in the attachment is a leading reason why it is thought to be so successful as a couple’s therapy. From a diversity perspective, the ability to adopt EFT to accommodate different religious or faith backgrounds is why this form of therapy can be successful for a multitude of different couples.
There are three main stages to the EFT model of couples therapy: de-escalation, restructuring attachment interactions, and consolidation and integration. De-escalation involves learning about and understanding negative interaction cycles that are perpetuating distress in the relationship. This can relate back to the previous example; when conflict occurs in the relationship is there one party who actively wants to resolve the situation and one party who chooses to remove him or herself? Restructuring attachment interactions are all about shaping new core emotional experiences and interactions to lead to a more secure attachment. Change in EFT is not achieved through insight, catharsis, or improved skills, but rather from formulation and expression of new emotional experiences as it pertains to attachment needs and emotions. What does each partner need to feel heard and understood? Consolidation and integration are the final of the three stages in EFT and can also be referred to as withdrawer re-engagement. During this stage, the partner whom previously avoided conflict and engagement with their partner openly expresses attachment needs and is more open and responsive to their partner.
The rooting of EFT in emotion and attachment makes it very flexible and therefore adaptable to couples of many diverse backgrounds. At Alongside You we love working with couples from diverse backgrounds and we have specific training in Emotionally Focused Couples Therapy. If this article resonates with you and we can be of help, please let us know, contact us, and give us a shout
by Andrew Neufeld | Mar 29, 2018 | Dialectical Behaviour Therapy, Education, Mental Health Disorder, Relationship
One of the most common questions I get from people when I give talks on Borderline Personality Disorder (BPD) and Dialectical Behaviour Therapy (DBT) is the question of how to support someone with BPD? So many individuals, couples, and families are struggling with how to love, care for, and support someone in the midst of what often feels like total chaos and painful experiences.
Shari Y. Manning, former President and CEO of Behavioral Tech and Behavioral Tech Research, the research organizations founded by Marsha Linehan to provide training in BPD, wrote a book on just this, titled “Loving Someone with Borderline Personality Disorder” and in it she focuses on how to keep the out of control emotions from destroying relationships between individuals with BPD and their families and other supports. She highlights the difficulty of balancing compassion for the person, while still wanting to help them find ways to change their behaviour and managing their emotions.
I’ll admit that it’s not easy to help someone struggling with BPD. It may seem that they are manipulative, egocentric, and focused on their own needs exclusively. The reality is that it’s not actually too far from the truth. The key to supporting someone with BPD without losing our own sanity, in my mind, is in our approach and how we frame what we’re observing. This is where Dialectical Behaviour Therapy (DBT) skills come in handy for us as well.
Interpersonal Effectiveness and Manipulation
Let’s talk for a minute about the idea that people with BPD are manipulative. It’s common to hear, both amongst clients with BPD, support systems, and yes, even professionals. I remember years ago that I used to get very angry when I heard this because I felt very compassionate toward clients with the borderline personality disorder and their need for help. Then it dawned on me – that is, they are being manipulative. And so are we.
See, manipulation is nothing new in relationships. We do it all the time – in fact, as I said to my intern John this week in supervision, we’re all in relationships to get what we need from the other person. None of us would be in relationships if this weren’t true. The difference is, we do it in a mutually beneficial way that serves everyone involved. The fact remains, however, that we’re all trying to get what we need from others, we just have more ability to do so effectively. This is what interpersonal effectiveness skills in DBT do for clients and for members of support systems; they teach us how to get what we need from others in an effective way.
Why Individuals with BPD Behave the Way That They Do
I remember back many years ago when I began working with individuals with developmental disabilities, we often repeated the phrase with staff and caregivers, “All behaviour is communication.” This is a very important concept and applies just as much to kids and adults alike, as well as individuals with BPD. When we can’t use words to communicate, we use actions. Further, when we see the often extreme behaviours of individuals with BPD, it’s important we remember what is happening to them at that moment, and how it got that way.
Personal history
We’ve learned from research that individuals with BPD have reasons for interacting with the world in the way they do, just as we all do! Linehan’s theory from 1993 is the most substantiated, and it suggests that BPD can be the result of the interaction between biological and psychosocial factors, including adverse childhood experiences. One of the predominant factors is invalidating developmental contexts where emotional expression is invalidated in childhood. Further research suggests that between 30%-90% of individuals have experienced abuse and neglect in their lifetime. This has a significant impact on the developing brain.
Brain Function
What we also know from brain science, and certainly I’ve observed this in my clinical work, is that individuals who have histories of abuse, neglect, invalidating emotional environments, and other traumas, have brains that are more sensitive to danger. The limbic system is designed to keep us safe and also regulate our emotions. At its’ best, it keeps us safe when we’re in danger, and regulates our emotions to keep us at an even keel. At its’ worst, it’s being triggered in situations that aren’t dangerous and causing us to react in ways that would make sense if we’re in danger but make no sense when we’re not. It’s also important to remember that when this system is acutely active, it shuts down our frontal cortex, which is where our rational thought mechanisms are housed. So, when we’re in danger, as I often say to clients, we can’t think to save our lives. This is the brain state that individuals with BPD are in when they react in extreme ways. Their brains are in full-blown fight or flight mode and simply reacting, trying to do anything they can to be safe. Most often, they turn to their closest relationships.
Relationships as Safety
Ever heard the idea that we hurt the ones we love the most? This is often the case with individuals with BPD when they react in extreme ways. But why is this? Many people with BPD have a very externalized locus of control, meaning, they don’t believe they can contain their own emotions, especially when they’re overwhelmed. You know what? They’re right. When they’re in fight or flight the mechanisms in their brain responsible for regulating emotions and behaviour are not rational, and are just reacting and they can’t contain it. This is simply a more extreme version of what happens to all of us. So then, what’s the difference?
I believe the difference is the level of fear experienced in these moments. The idea of not being able to contain extreme emotions would be, I imagine, quite terrifying. Coupled with the fear of being left by the people they are closest to, the proverbial pot boils over and they have to do something extreme to get attention. I often hear, “Oh they’re just attention-seeking,” to which I reply with an emphatic, “Yes, of course, they are!”
Remember the idea that all behaviour is communication? When people with BPD are at this heightened state they are unable to communicate effectively and are doing their darndest to communicate their pain and fear to us, asking us to help them contain it. What may look to us like someone simply showing out of control behaviour, I believe, is a desperate attempt at seeking safety and containment.
Can you imagine what it would be like to be in this position? Having BPD, feeling so unsafe and so in pain that you have to go to such extreme lengths to try to get help? I can’t. The idea of being there is far too terrifying to me. Quite frankly, I don’t want to know what it feels like to be in that place, but it gives me a great deal of compassion for those who are.
What Do We Do To Help?
One of the best ways to be supportive is to help those struggling with BPD to get the help they need. Dialectical Behaviour Therapy (DBT), on an individual basis as well as in skills groups, is very effective in helping those with BPD manage their symptoms. With the right help, individuals with BPD can learn the skills they need to manage their emotions and relationships and ultimately, have a life worth living! This was Marsha Linehan’s goal in developing DBT, to help those struggling with suicidal thoughts have a life worth living. We’re proud to say that our DBT programs have been effective at doing just that for our clients, and we’d love to help even more people this way.
We have often been asked if we run groups for family members and other supports who are trying to help someone with BPD. Unfortunately, we don’t at the moment but it’s on our radar. We are looking into doing exactly this in the future. What we can do, however, is teach DBT skills on an individual or family basis for those supporting someone with BPD. We have a number of counsellors available for this, and you can talk to Doug, Share, or Kelly about this if it would be helpful.
Education is also very important as once we understand what is happening, it gets less scary. There are many books that can be very helpful. Here are a few ideas to get you started:
Stop Walking on Eggshells by Paul Mason
Loving Someone with Borderline Personality Disorder by Shari Y. Manning
DBT Made Simple: A Step-by-Step Guide to Dialectical Behavior Therapy by Sheri Van Dijk
Finally, self-care is absolutely paramount to your survival for yourself and the person struggling with BPD. As the airlines often remind us, we need to put our mask on before we can help anyone else! If we don’t take care of ourselves, we will flip our lids and react in much the same way as those we’re trying to help.
I hope this has been helpful – if our team can be of any help to you as you support someone with BPD please feel free to give us a shout. Our Dialectical Behaviour Therapy program is comprehensive, and we would love to teach you the skills needed to be a solid support, for yourself and your loved ones with BPD!
by Andrew Neufeld | Feb 15, 2018 | Counselling, Love, Relationship
I’ll admit it right off of the bat – I’m a hopeless romantic; always have been, always will be. Little known fact about me is that while Meg and I were dating, I was voted Most Romantic Man in Vancouver by my friend who owned the local flower shop. But that’s a story for another day. Needless to say, I am indeed a fan of love. I suppose that’s why I became a marriage and family therapist – if we’re destined for love, I wanted to have a positive impact on the type of love we have.
Here’s the problem – Valentine’s Day kind of sucks. Or at least, that’s often the impression we’re left with. You’ve probably heard it all by now, “It’s too commercialized…it’s a scam by the retail industry…they just wants our money…I hate pink…,” and so on and so forth. Well, here’s the thing, the people saying these things aren’t totally wrong. Valentine’s Day is very commercialized, retail outlets do scheme to make money on the holiday, and they do want your money, and some people really do hate pink. I’ll even admit that as a self-proclaimed hopeless romantic, I sometimes get tired of the hoopla around a single day, and the fact that I’m often behind the 8-ball and running around last minute trying to figure out what to do.
So, I reflected on Valentine’s Day this year while I was making some of the preparations, asking myself what it is that I find important about Valentine’s Day, and why I make the effort. Here are the three reasons I came up with this year:
- Relationships are important, and it’s okay that we celebrate this. Furthermore, it’s so easy to overlook relationships when we get busy and the advantage of having Valentine’s Day is that it forces us to remember the importance of our relationships, and particularly our romantic ones.
- Valentine’s Day doesn’t have to be about romantic love. Every year, we give our kids Valentine’s Day cards and gifts, but I wanted to do something slightly different this year. I am fortunate to have an incredible wife and two amazing daughters. This year, I gave them each a journal and inside, I wrote a message to each of them about something specific that I believed about, hoped for, and appreciated in them and that my hope was that the journal would be a place where they could reflect on these things in the coming year. I wanted to make sure that each of them knew how special they were, and uniquely so. This is something we can do for anyone special in our lives – a repurposing of the original intent perhaps?
- Being reminded of love reminds us of the importance of connection. Attachment and connection are two of the most important things in life, and a reminder to us that we are indeed relational beings who thrive on relationships with others. Also, by loving others, we remind ourselves that we, too, are worthy of love. If we are enamoured with someone we think is incredible and know that they choose to be with us, then either we must also be special, or they must be delusional for spending time with us. I don’t know about you, but I’m pretty sure the former is more likely and true. Sometimes we need this reminder in life, especially if we are struggling.
Now, for some of you, Valentine’s Day is a painful reminder of the romantic relationship you don’t have that you long for. I can only imagine what that’s like. What I do know, is that you are worthy of love, romantic or otherwise. My hope is that while your Valentine’s Day may not have been about romance this year, perhaps there was a reminder of how someone in your life values you.
To take a slightly different spin, some self-compassion can go a long way. I’m going to suggest an exercise here, both for those in romantic relationships and those who aren’t, and it may sound a little weird. I’m going to suggest writing yourself a love letter. Yes, I said write a love letter to yourself. Why? Because self-compassion is simply taking the compassionate stance we find so easy to give to others, and turning around and giving it to ourselves. Most of us are our own worst critics – it’s so easy to see, and pounce on our own faults. We’d never say half the things to someone else that we say to ourselves.
To flip it around, I find it so easy to write a letter to my wife or my kids. I can immediately think of so many things I think are incredible and unique about them, and my hopes and dreams for them. I find it much harder to do this for myself, but it’s an important exercise because it affirms our own worth, our uniqueness, and our status as worthy and deserving of love and compassion.
I know it may sound weird, but I’m going to challenge you to try it. It may sound like a strange counselling exercise that only a Registered Clinical Counsellor or therapist would suggest, and you may be right – but that doesn’t mean it won’t be helpful. If you do try it, I’d love to hear your experience and how it impacted you. Please feel free to contact me through the website with your feedback, even if you just want to reiterate how much Valentine’s Day sucks. That’s ok, at least we’re connecting. But I would be very surprised if you could do this exercise and not find something helpful in it.
If you’re struggling with your relationship with your significant other, or your relationship with yourself, we’d love to be of help. Please contact us or give us a call, that’s what we’re here for.
