DBT: Families on the Line Using Dialectical Behavior Therapy
The website Families On The Line, created by Marie-Paule de Valdivia, begins with an unusual welcome.
I am guessing you are here because you are exhausted. And perhaps also scared, and 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 frequently “out of control.” This is 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. Borderline personality disorder (BPD) soon defined. Quite honestly, what we see as the internal life and accompany family effect of a person with borderline personality-disorder could apply to other diagnoses as well. A diagnosed person’s internal life and family effect could apply to other diagnoses as well. As such, its message is truly hopeful.
The reason Marie-Paule created the website comes closer into view:
“You want to help and be there for them, but 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. They recognize that 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 for their daughter. They decide to throw themselves behind it and share their story. She decides to go back to school to earn an MSW. She now speaks professionally on borderline personality disorder. Further, she 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 is an invited presenter at National Alliance for the Mentally Ill (NAMI) conferences throughout the country. She helps people see 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 improving 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, her father and I were very overwhelmed and had no sense of where to turn. Despite the fact that she was seeing therapists while her life which had been full of promise came to an abrupt stop. It was filled as it was with impulsive and dangerous behaviors. 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 by discovering the description of BPD symptoms 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 goes back to school, she is given an “extraordinary opportunity.” The option to complete her second year practicum in the Yale New Haven Psychiatry Hospital DBT Program. She mentions that this gives her a “well rounded view of BPD.” Ever since, she dedicates herself to helping patients and families. Perhaps most importantly, “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. 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.
Combativeness and hostility, extreme rigidity in thinking also play a huge part in their life. They are known in the mental health profession as being the hardest to reach and are often scapegoated within support groups.
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 are familiar with the stigma of their daughter’s BPD diagnosis. 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.” It can, however, be used “to treat other parallel (co-morbid) illnesses or to take the edge off some severe symptoms.”
Validation from family is part of the training. 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 rigid thinking into multifaceted thinking.
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.