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How Physical Illness Impacts my BPD & How I Manage

A few days ago, I was struck down with a virus of sorts and have been croaking, coughing and generally feeling rough.

My emotional resilience is down as a result of being unwell. My emotions have been even quicker than usual to flare up. Last night, I jumped to the conclusion that I had been excluded from an event and cried for about half an hour. Although it turned out that this wasn't the case at all, I managed to tell myself in that moment of intense emotion that my sadness was stronger because of several vulnerability factors.

I learnt about vulnerability factors during my DBT group. Vulnerability factors are elements that make a person more susceptible to becoming distressed such as being tired, hungry, having a lot of stress and being physically unwell. I know all too well that when I am in need of food and rest, I am more likely to misunderstand someone, get triggered, have a sobbing fit, panic or feel helpless. This was the case last night.

One thing that has helps is noticing that when my vulnerability factors stack up, I am more likely to feel distressed. Reminding myself of the impact of vulnerability factors on my emotional state took the pressure off feeling 'better' and I could focus on eating and resting. In this instance, instead of trying to feel less sad which didn't feel like an option there and then, I made a disciplined choice to sit down, eat and rest.

In DBT there is an acronym for managing vulnerability factors known as PLEASE. The acronym doesn't really work as an acronym, but hey, it's in the book

I don't take any non-prescription drugs and never have, so that's not something I have to think about with PLEASE skills, but all of the others are fundamental for the management of my BPD. I learnt about PLEASE skills many years ago, but only started to do them properly in the last couple of years. This is because I used to think I deserved to suffer emotionally, so I had little motivation to care for myself physically. Thanks to DBT, I have learnt that I am worthy of taking myself.

Here's to this virus disappearing soon! Do you find PLEASE skills helpful or not? What others skills do you find helpful when you're physically unwell? I would love to hear from you!


1. DBT Skills Training Handouts and Worksheets, Second Edition, 2014 by Marsha M. Linehan


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