This is a guest blog by Linda Hoenigsberg, LCPC, LMFT, DBTC --Randi Kreger
“He knows how much this bugs me!” “She waits until I’m busy with something and then starts in on me!” “He just does that to get attention!”
I often hear comments like this when I meet with family members of clients who suffer from borderline personality disorder. Loved ones who struggle with understanding how a person can act reasonably one day and completely unreasonably the next can deny the reality of the illness. A war of wills and the endless cycle of conflict ensue. The Dialectical Behavior Therapy (DBT) skill “radical acceptance” can minimize the blame game and change the dynamic and bring a renewed sense of peace into the home.
Marsha Linehan, the developer of Dialectical Behavior Therapy, explains the term radical as a “complete and total…[accepting] of something from the depths of your soul.” It’s not a behavior. It’s an interior shift. It’s all about finding peace in “what is” the reality of the situation right now. Acceptance is the opposite of denial.
But how do you actually do this?
First, accept everything about your family member just they way he or she is today. This means giving up the fantasy that they could control their feelings if they just tried harder. The dance that is denial can make a person either overly optimistic (my family member acted appropriately this time, therefore he or she will always act appropriately in the future) or overly pessimistic (this is a nightmare that is never going to get better for any of us).
Second, understand that the situation causing you pain has a cause. Learn all you can about the illness so that in the midst of unpleasant interactions you will remember the reasons your family member may be acting out. Visualize a slot machine in place of the emotional part of the brain when a family member is raging. “Ka-ching! ka-ching! ka-ching!” Words come out of their mouths faster than tokens flying out of the coin tray. When you can separate your family member from their behavior, your next words will be more likely to bring calm to the chaos.
Third, don't let intermittent reinforcement throw you. As you know, every once in a while your loved one will act as though they didn't have the disorder after all. That may often be at work, around people they don't know well, or when they're in a really good mood. It is tempting to reverse yourself and decide that everything is really all right and you can throw this "acceptance" business out the window. Don't give into temptation. It's really splitting or magical thinking. Accept that these mood shifts are part of the disorder.
Radically accepting your life and all it includes when you have a family member who has been diagnosed with borderline personality disorder does not mean letting go of hope for a better life. It does mean letting go of unreasonable expectations and denying the reality of the illness. In Lawley and Tompkins Metaphor of the Mind, the authors state that “truly acknowledging ‘this is the way it is’ and accepting ‘current reality’ is the first step on the road to transformation.” Anything less leads to frustration, anger, grief and more suffering for everyone. Practicing radical acceptance can bring more peace and prepares all members of the family for the change they so desire.
Linda Hoenigsberg, LCPC, LMFT, DBTC, is a psychotherapist in private practice. She lives in the Rocky Mountains of Montana with her husband and goldendoodle Emma. She blogs about DBT mindfulness and other matters of the heart and mind at http://www.lindahoenigsberg.com