Families on the Line Using Dialectical Behavioral Therapy
The website Families On The Line, created by Marie-Paule de Valdivia, begins with an unusual welcome. (Only if you’re a stranger to mental illness, that is.)
I am guessing you are here because you are exhausted. And perhaps also scared, and so very sad. But hanging on to a little bit of hope … You are a mom or a dad, a sibling or a spouse, or an adult child of someone who is so frequently “out of control” — either with anger or with sadness. This person in your life experiences a lot of emotional dysregulation, you see that they suffer greatly, and you do too ….
The welcome for the weary who land on this site continues, with borderline personality disorder (BPD) soon defined. Quite honestly, what is depicted as the internal life and accompany family effect of a borderline personality-disordered person could apply to other diagnoses as well. diagnosed person’s internal life and accompanying family effect that could apply to other diagnoses as well. As such, its message is truly hopeful. (The crux of commonality is the emotional dysregulation also evident in the life of some with bipolar disorder and obsessive-compulsive disorder, the acutely anxious, or others of the personality disorders. The characteristics, though, are especially pronounced with those suffering from BPD.)
The reason Marie-Paule created the website comes closer into view:
You want to help and be there for them, and you don’t know how. Most of what they do makes little sense to you. It feels like most attempts to help, or connect, result in worst crises, although sometimes you do feel you are being helpful. You are given lots of advice, and you know friends and family mean well yet don’t really get what it’s like.
Marie-Paule and her husband did latch onto something they could do, however, for their affected daughter. They decided to throw themselves behind it and share their story, and she decided to go back to school to earn an MSW. She now speaks professionally on borderline personality disorder and tells her tale of how Dialectical Behavior Therapy (DBT) changed her family dynamic.
Marie-Paule teaches these skills through the NEA-BPD, the National Education Alliance for Borderline Personality Disorder. She has been an invited presenter at National Alliance for the Mentally Ill (NAMI) conferences throughout the country, helping people begin to see, just as the website describes, that “It takes determination and desire to change. [DBT] will not resolve all, but this type of therapy is good news that will take you and your relative a long way towards an improved family life.”
Following is Marie-Paule’s depiction of the more specific journey that brought her into the Dialectical Behavior Therapy fold:
When our daughter’s illness became evident a few years ago, her father and I were very much overwhelmed and had no sense of where to turn. Despite the fact that she was seeing therapists, for about a year we floundered about, while her life which had been full of promise came to an abrupt stop, filled as it was with impulsive and dangerous behaviors. Yet no one brought up with us the diagnosis of BPD. And when she turned 18, of course no one discussed anything with us at all anymore. It is only when I discovered the description of BPD symptoms on the website of a well known psychiatric hospital, that all became clear.
Our daughter went into treatment. We took the NEABPD Family Connections class. Things improved vastly, both at home and for her. There were bumps in the road, but the progress was marked.
I started teaching Family Connections, I could see the profound effect on families and loved it….
When she went back to school, Marie-Paule was given an “extraordinary opportunity,” to complete her second year practicum in the Yale New Haven Psychiatry Hospital DBT Program. She mentions that this gave her a “well rounded view of BPD, from a parent’s as well as from a clinician’s perspective.” Ever since, she has been devoted to helping patients and families. Perhaps most importantly, she states, “Our family is solid and our daughter is full of a kind of hope and promise we could not have imagined.”
Families on the Line, as well as Marie-Paule’s talks and workshops delineate the dysfunction and anguish prevalent for the person with Borderline and his or her family. (See the criteria for a diagnosis of BPD.) Remember that symptomatology is key when it comes to finding coping measures and strategies that help; also remember DBT strategies may resonate with you even if an entirely different group of symptoms present themselves.
For sure, those with Borderline Personality Disorder have trouble with interpersonal relationships, and can be very impulsive. Severe emotional dysregulation, emotional immobilization and significant debilitation can result, according to Marie-Paule.
Combativeness and hostility, “extreme rigidity” in thinking also play a huge part in their life, she states. They are known in the mental health profession as being the hardest to reach and are oft scapegoated within support groups. (I more than once witnessed normally compassionate and accepting NAMI members and professionals apparently attempt to feel better about the diagnosis of a loved one suffering from mere “depression”–but who periodically contemplates and attempts suicide. For when the personality disorders are equally discussed, what is palpable is that the pain of individuals with Borderline, and family life with them, may be too severe. Such stigmatization of people with Borderline Personality Disorder and their loved ones cuts deep, unbeknownst to those that should know better.)
Marie-Paule and her husband certainly have been familiar with the stigma of their daughter’s BPD diagnosis (or even suspicion). It was because of the agony of feeling helpless, however, that they jumped into learning and promoting DBT. “Medication is not so generally effective for BPD,” states Marie-Paule. It can, however, be used “to treat other parallel (co-morbid) illnesses or to take the edge off some severe symptoms.”
Validation from the family is part of the training, according to Marie-Paule in a phone interview — not “liking” the diagosed person’s behavior but being able to understand it and reiterate that understanding to the individual. It also helps to open up formerly rigid thinking into multifaceted thinking (not just by the affected individual but also the family, who gets caught in the traumatic circle).
After the NAMI breakout workshop, Marie-Paule had stated to the small-group family huddle forming, “You can be good to the person suffering [from BPD]. But being good to them doesn’t mean that you are necessarily effective.” DBT strategies can help families break through the agony to see real behavioral change. “Incredibly effective,” is how she describes it.
((This writer attended the Southwest Pennsylvania NAMI spring 2013 conference in which Marie-Paule visited and gave a featured talk, as well as a breakout workshop on the specialized therapy. A NAMI group that I am involved with is now embarking on a joint NAMI/NEA-BPD Family Connections class where several people will learn DBT, and a couple of those will go on to become trainers in the method (myself included). This appears to be too valuable a strategy to pass up, one that can bring innumerable benefits to so many. See my blog post on how DBT is for more than just mental illness, and look for a future in-depth article on the actual training from our class with Marie-Paule.))
Miles, L. (2013). Families on the Line Using Dialectical Behavioral Therapy. Psych Central. Retrieved on February 10, 2016, from http://psychcentral.com/lib/families-on-the-line-using-dialectical-behavioral-therapy/