I am a 21 writer from Italy who has been suffering from BPD since at least age 10 [pronouns: she/her]. I study at “Scuola Holden: the writing academy”, an Italian writing major for undergraduate students. For about a year now I have had my own blog: “Dysfunctional Girl” and greatly enjoy writing it, as one can guess from my choice of major. It is a cathartic experience that helps me daily. —Yours sincerely, Dysfunctional Girl Do you find having a diagnosis of BPD helpful or unhelpful? I have always known there was something different about me. When the other kids played, I would sit alone and read; I would adapt to people like water in an empty container; I always felt at ease… I was too young to be diagnosed with BPD [during] my first few inpatient experiences, but when they finally did bring it up, I remember thinking: “Oh god, that’s me. I’m not crazy!”. [My diagnosis] has helped me. Firstly, it helped me accept and now it helps me understand and try to modify my behaviours. What do you most want people to know about BPD? Something very important to me is explaining the meaning of “loss”, “pain” and “survival” for those diagnosed with BPD. Our emotions are heightened: we do not feel anger, we feel rage. We do not just feel happiness, we feel euphoria and, more importantly, we do not just feel anxiety, we feel panic. These strong emotions trigger a flight or fight response which we sometimes cannot manage, and I believe it is wrong to be judged for something out of your sphere of control. What advice would you give to someone newly diagnosed with BPD? You may have suspected this for some time and not be surprised at all. You may feel genuinely relieved because you finally received and explanation for your behaviours. You also may feel scared and not know what to do. My advice? Ask for help. Professional, obviously, but also from those who can understand. There are many communities out there and they have been life saving in moments of difficulty. With all the stigma surrounding the illness, at least those of us who have it should band together. What advice would you give for the loved ones of someone with BPD? Please be patient and remember: “It’s not their fault.” We try, hard, to keep our emotions at bay, but just like a child struggling with his homework, we cannot always succeed. If you are a sufferer’s favourite person, I understand it may be difficult: being everything to somebody is a hard position to be in. Just remember, a single word from you can change the sufferer’s day, so make sure you do not overexert yourself or more harm than good will be done. How do you feel when you hear stereotypes about people with BPD, such as the myth that people with this condition are attention-seeking or manipulative? Honestly, I feel mad. I know it is just the result of misinformation, but: needy, selfish, manipulative, clingy… These are all terms I’ve heard way too often referred to someone who suffers from BPD. The truth is, maybe sometimes our behaviour may appear that way, but it is because we have a disability. That is not us, we are what’s left once all this is removed. What would you say to someone with BPD who is feeling hopeless and like things will never get better? This is a poem I wrote recently about one of those bad days. Sometimes you are okay. Sometimes not, however, no matter how hopeless you feel, there is always hope. Run, I must run. Run. I'm running, life thrown at me as I glide through time, struggling to reach what is not possible to reach. Flashes, glimpses; shards of spacetime penetrating my flesh, tearing me apart. Run. I must run. It's too much. Life; uncertain, uncontrollable. A string of senseless senseful events, piling up on my shoulders and pinning me to the ground. Run. Keep on running. Scream, cry, tear through the mountains of distractions. Ignore, deflect. Run. I must, and so I do, until I forget why I even started. My weary limbs may be failing, yet I must run. Run on, go on. Run. I must try. I can't let go. It's important. I'm suffocating; it doesn't matter. Run, until my legs give out. Run. I can't stop. Run. Run. Run. And that's when I saw the light. I finally stopped running. Thank you so much Dysfunctional Girl for sharing your thoughts and experiences. I agree with you about how helpful communities of people with BPD can be. I recommend BPDChat (a weekly 'chat' on Twitter which can be found by searching with the hashtag #BPDChat) to anyone who wants to learn from others with the condition. I find it very interesting that you feel you are 'what's left', as though you are the person behind your BPD. Sometimes I relate to this, but mostly I feel that my intense emotions are a key part of me and without them I wouldn't be the person I am. Thank you for sharing your poem which holds a beautiful message. Wishing you all the best with your studies at the writing academy! - Rosie Read more by Dysfunctional Girl on her blog.

*Update 06.09.20: Most of the videos have now been published on my channel. *Update 01.07.20: I am so sorry, but I have had to postpone this video series as I have been struggling a lot (haven't struggled this much for around two years!). I am focusing on trying to feel better and regain my balance. I hope to do these videos at a later date once I feel better. I am so sorry to those of you who were looking forward to it. I am okay and starting to feel a tiny bit better already.* After years of doing therapies that were not fully effective in helping me manage intense emotions and episodes of severe distress, DBT finally offered me some solutions to my problems. Mental health care is an incredibly unfair postcode lottery. Moreover, people with BPD tend to have a much harder time accessing care than people with other mental health conditions for a number of reasons that I will save for another post. -scroll down for schedule of daily DBT videos- I wasn't able to access DBT until about four years after I was first diagnosed with BPD. As soon as I started on twice-weekly eighteen month programme, it felt 'right' for my needs. It was like coming ashore after being shipwrecked for so many years. I have shared quite a bit about DBT and how it has helped me on this blog, my YouTube channel and my social media. However, wanted to share more about DBT skills with you as I know just how useful and reassuring they can be. They have certainly helped me avoid many a crisis over the last two years. So, this July I will be doing 14 videos about 14 different DBT skills. For two weeks, I will post a new video at 11am BST on my YouTube Channel. Just to let you know, these videos aren't any substitute for professional, intense DBT led by a specialist. I won't be following the manual down to every last letter. Instead, my videos are here to give a lived-experience perceptive. I am not afraid to tailor skills to suit my own needs & life. These videos will give insight into how I do that. I work hard at my DBT skills, but I also make them work hard for me. Daily DBT Schedule for July 2020 1st July - observe and describe 2nd July - non-judgmental stance 3rd July - identifying emotions 4th July - opposite action to emotion 5th July - self-validation 6th July - turning the mind 7th July - radical acceptance 8th July - cope ahead (worst case scenario) 9th July - improve the moment 10th July - 'PLEASE' skills 11th July - 'FAST' skill 12th July - 'DEAR MAN' skill 13th July - How do I know which skill to use at a given moment? 14th - Summary: Q&A video I thought these videos could be helpful for several groups of people: People who haven't been able to access DBT so far and are trying to teach themselves (as I once did). People who have finished DBT who want a 'refresher' or who miss hearing learning from their peers during the DBT group sessions. Anyone curious to hear a lived-experience perspective (I am not a therapist!). As always, I will share my own tips and my own challenges. DBT is famously hard work and incredibly demanding. As you will know if you have your own experience, there is a lot of content to learn and a lot to practice. How I use the 'STOP' skill > If you want to learn more about DBT, what it is and how it might help you, before July 1st, check out the the DBT introductory video I made about my experiences. I also have a couple of book review videos on my channel about two of my favourite DBT books. Also, I highly recommend having a look at the wonderful Debbie Corso's DBT videos. She has been an inspiration and source of comfort to me over the years. dbt Introductory vide > Hope you will join me for a new video each day starting July 1st! Let me know if there is anything you want to see covered that's not in the schedule and I will do my best to address it! If you like what I do, please consider helping towards my running costs by supporting me on Ko-Fi. Your help is much appreciated.

Daria Deptuła (pronouns: they/them) is a student of History and Creative Writing at The University of Texas at Austin. They have had two original short stories published online. Do you find having a diagnosis of BPD helpful or unhelpful? Receiving my BPD diagnosis in June 2018 cleared up much confusion I had about myself. I didn’t know a good deal about the disorder beforehand, except that a few people whom I knew had it. As my psychiatrist listed off the conditions for a diagnosis, I was shocked to find myself nodding at each one. Having a diagnosis gives me a useful framework with which to make sense of why I feel and act the way that I do. What do you want people to know about BPD most of all? Having trouble with emotional regulation does not equal an “overreaction.” Even if an event might seem small to an observer, the intense emotions that it causes someone with BPD to feel are real and valid. These intense emotions can make going through the motions of everyday life a big challenge. Know that I am trying my best as someone with BPD, and so is everyone else. How do you feel when you hear stereotypes about people with BPD, such as the myth that people with this condition are attention-seeking or manipulative? It hurts me to my very core. I’ve had people close to me believe those stereotypes and treat me accordingly. At the time, that treatment made me feel as though I was unlovable and undeserving of support. The “attention-seeking” myth especially upsets me, because people in crisis do need support and should not be discouraged from seeking it! What advice do you have for anyone who is newly diagnosed with BPD? Resist the urge to Google the diagnosis. Ask your mental healthcare provider any questions you might have about your symptoms. I find it personally helpful to track my moods and urges, so that I can notice behavior patterns that do not serve me and intervene. I use a handwritten journal, but there are also downloadable calendars and apps available for free online. Lastly: this disorder affects many aspects of your life, but it does not define you. What advice would you give for the loved ones of someone with BPD? I personally struggle with emotional permanence, put simply as the ability to remember that people care about me when they’re not actively expressing it. Many other people with BPD face this challenge. If your loved one has BPD, try reaching out to them when you’re thinking of them—even if with nothing but a short “good morning” text. The little things aren’t little. What would you say to someone with BPD who is feeling hopeless and like things will never get better? One thought that gives me hope when I have trouble finding it is that change is the only constant. I don’t know how I’m going to feel next week, tomorrow, or even in the next hour. I tell myself that I just have to make it through the next hour, and then things will be different. They usually are. I might not go from depressed to joyous within that hour, but change always comes. I also tell myself that every single time I thought I wouldn’t survive a crisis, I did. And I will again. And you will too. Thank you so much Daria for sharing your thoughts and experiences. I am so glad that your diagnosis has given you a useful framework for understanding how you feel and what can help. It hurts so much when people you know bought into the stereotypes and treated you in line with them. From now on, I hope people treat you with nothing but the respect and understanding you deserve. I love how you have pointed out in your post that the 'the little things aren't little'. So true! Wishing you all the best with your short stories and your degree. - Rosie More from Daria Deptula: Twitter @DeptulaDaria Writing Short Story: "A Dead Message" in Cleaning Up Glitter Anthology: "Courage is a Gift and Other Stories By and About Transgender, Non Binary and Genderqueer People"

I am a teacher and a person with a diagnosis of BPD. Those two things are not mutually exclusive and, in spite of what the stigma might say about people with borderline personality disorder, I am very good at what I do. When I was first diagnosed with BPD back in 2014, I was scared that I would not be able to get a job working with children because of my BPD. I was worried that employers would find out about my BPD and judge me as incapable, unreliable or even unpredictable. I am none of those things and never have been. Of course, sometimes having a job has been incredibly hard on top of managing my BPD. This was especially the case in 2014-2017 when I didn't have nearly enough specialist support. Video about my career so far... You *can* have a career in a helping profession when you have a BPD diagnosis > Your career plans are not ruined Many people who are newly diagnosed with BPD worry that their career plans are ruined. This is understandable given the stigma surrounding this mental health condition. When I was younger, my fear was always to do with being stigmatised or discriminated against at work, rather than a worry about not being able to do the job. I have always known I could do my job well. Due to reading some incredibly hurtful things about BPD online and in books, I was so scared that a boss would turn around to me at any moment and say: 'so I found out you have BPD... I'm sorry, but we cannot have you working here any longer.' I know that employers cannot generally access medical records, so maybe this was partly an irrational fear. I know though that discrimination on the basis of a mental health diagnosis is very real. It's so scary thinking that discrimination may bite at any moment. As a young person at the beginning of a career, I was so worried that my aspirations to build a career in a helping role would be ripped from me. That never happened and I am happy to say things have always worked out well for me. I have had a lot of praise for what I do and I derive a lot of satisfaction from being able to help others. being Emotionally Sensitive Helps Me in my career I work with children who experience emotional dysregulation and sensory processing difficulties on a daily basis. As someone who has felt some pretty intense and extreme emotional states over the course of my life, this gives me empathy. I have felt very helpless and fragile throughout my adolescence, I take a lot of care when others may be feeling vulnerable. I try hard not to judge because I have been judged and remember how much that hurt. I also know that a strong rapport/relationship is the fundamental basis for learning and growth. This makes me invest a lot of time and effort in getting to know someone and finding out their likes, dislikes and preferences. Due to my BPD and not always having the help I have needed, I have had to be creative in order to help myself. I apply this resourcefulness to my work, especially as I work with children who often express themselves through non-verbal modes of communication. The 2010 Equality Act In the UK, people who have a disability (either mental or physical) as outlined under the 2010 Equality Act are protected by law from discrimination and are entitled to certain 'adjustments' in the workplace. It is well-worth reading up about these laws to make sure you are being treated fairly at job interviews, as well as in the workplace generally. However, I know that these laws are not always completely watertight and there is some way to go before all workplaces are fair and respectful. Information on mental health problems, disability and the Equality Act. End the shaming of people who are not working I really dislike the pressure, mainly from the government and its related institutions, that is put on people to work when it is impossible or is detrimental for their mental health (or health in general). Nobody with a mental health problem should ever be forced into work or be told that they are only worthy of respect, care or understanding when they are working. Many people criticise 'recovery-focused' mental health care as forcing people back into work before it is safe or beneficial for them. It seems that some 'recovery-focused models push people to feel 'better' for the sole reason that they will be able to go back to work. Getting someone back to work' should never be the 'goal' of someone's 'recovery', unless that is what they explicitly choose for themselves. Reform Universal Credit As the benefits system in the UK is completely unfit for purpose, I can understand why people need to go to work even when it is damaging for their mental health. With a benefits system as punishing as it currently is sometimes people have no choice but to go to work, even when it harms their mental health. When the choice is food or endangering your mental health, food will take priority. People ought to be supported with their mental health not to get them in work, but because everyone deserves to be supported. Surely supporting mentally ill people is fundamental to a decent society. Self-worth is not synonymous with productivity The capitalist society that we live in teaches children from a young age that their self-worth is synonymous with their productivity. However, a person's inherent value and worth has nothing to do with how 'productive' they are. More often than not anyway, productivity is a euphemism for 'increasing profits for your employer'. I feel that people with mental health problems and disabilities who cannot work or who need to not work in order to stay healthy, safe or alive often bear the brunt of this damaging myth. As this conflation of productivity with self-worth myth has infiltrated the popular imagination, is it any wonder that so many people feel guilty or ashamed when they cannot work? It honestly breaks my heart when I hear people with a disability or a mental health problem feeling embarrassed or believing that they are useless because they cannot work. A person is so much more than their ability to go to work and do a job. More needs to be done to support people with disabilities, both working and non-working people Of course work is a vital source of self-esteem for many people (as it is for me), but nobody should ever be shamed for not being able to work. The social support system need to be dramatically overhauled and made safe for people with disabilities; universal credit is absolutely not fit for purpose. Much more needs to be done to support people with disabilities in the workplace, just as much more needs to be done to stop the shaming of people who cannot work. I believe that pushing against ableist attitudes and policies is the way forward. Employers need to actively work towards recruiting disabled people for the benefit for their workforce and then make sure they are flexible, creative and open-minded enough to work with an individual's disability and not against it. Adapting and embracing someone's disability will benefit every person in the workplace and the workplace as a whole, not just the person with the disability. One size doesn't, and shouldn't, fit all in the workplace. Hours, locations, modes of working, technology, working relationships, management systems all need to become much more pliable. Have you ever noticed that the 'higher up' someone is in a company, the more flexibility they have over their working hours, days and conditions? If this doesn't filter down when an employer presents itself as fair, then this is hypocrisy. Furthermore, there needs to be a drastic rethink of what productivity means, why it is held up as a pinnacle of goodness in society and why someone why a person's worth does not equal their productivity. A person ought to be judged on their character, not by their so-called productivity. I wonder how you feel about this topic? No matter what, please know that your worth as a person is not defined by how many hours of work you do, emails you send, boxes you pack, your salary or your job title.

I have noticed for a while now that psychotherapy (as well as psychiatry) is an extremely white dominated profession, both in terms of its theories and the number of therapists that are white. It has been too easy for too long for therapy to serve and be accessible to white people and white people only. This is not fair and this is not okay. In her book The Challenge of Racism in Therapeutic Practice, transcultural psychotherapist, trainer and supervisor Dr Isha McKenzie-Mavinga writes about 'the myth that the work on racism is finished'. McKenzie-Mavinga explains that this myth 'inhibits the explicit engagement of black issues in the therapeutic process'. She writes that the 'lack of opportunity to express hurt caused by oppression contributes to internalized oppression. The oppression is sometimes re-enacted against the self and others causing low self-concept and feelings of powerlessness.' The Black, African and Asian Therapy Network (BAATN) is the UK’s largest independent organisation that specialises in 'working psychologically, informed by an understanding of intersectionality, with people who identify as Black, African, South Asian and Caribbean'. Undeniably, psychological services are designed by white people with white people in mind. Black, Asian and Minority Ethnic (BAME) people get a raw deal when it comes to mental health for so many reasons. BAME people are more likely to live in poverty, have higher rates of unemployment, lower educational outcomes and experience more barriers to accessing mental health services than their white counterparts. A report by The Mental Health Foundation provides some useful information and statistics on BAME communities and mental health which I recommend having a look at. One of the aims of the BAATN is to 'address the inequality of access to appropriate psychological services for Black, African, South Asian and Caribbean people'. The BAATN works in partnership with 'white majority therapy and training organisations that recognise racism, and the importance of undoing the impact of racism, as an essential part of being mentally healthy'. The network explain that their overarching goal 'is the individual and collective processing of our inner experiences for the benefit of ours and other communities, and to give a voice to a ‘black empathic approach’. The 'black empathic approach' is a term that was coined by Isha McKenzie-Mavinga (2009). McKenzie-Mavinga described this 'approach as understanding and paying attention to the emotions evoked by racism.' This approach is rooted in empathy and is about giving responses that 'sensitively relate to a client’s racial and cultural experiences as they express them and as the therapist intuitively recognises them' (2009). ‘A black empathic approach’ points us towards a connection to feelings about difference and sameness, and a shared understanding of racism', writes McKenzie-Mavinga. The vast majority of psychotherapy training programmes do not help therapists (the majority of whom are white) develop nearly enough tools to address and work sensitively with white privilege, racism and race-based trauma or abuse in the therapy room. Importantly, the BAATN 'seeks to influence the integration of this [black empathic] approach into mainstream psychotherapy training, literature and practice.' I don't have statistics on it, but I would imagine many BAME people are harmed by therapists who have not integrated 'a black empathic approach', or a similar approaches, into their practice. I don't have statistics but I am sure that some therapists hold very problematic, damaging and racist views. As a white person I have not experienced this for myself first hand. This is because I am protected by my white privilege. I am looking forward to learning more by reading more books and blogs on this topic. For as long as psychotherapy continues to be designed by white people for white people, BAME people will not have equality in the mental health system. Things have to change and the more people in positions of power address their white privilege and its workings within their profession. I am a teacher and I know my own profession has its own version of white privilege that negatively impacts BAME children. A few days ago, Public Health England finally published the review into the disparities in the risk and outcomes of COVID-19. The review shows that 'people of Chinese, Indian, Pakistani, Other Asian, Caribbean and Other Black ethnicity had between 10 and 50% higher risk of death when compared to White British people.' It showed that people of Bangladeshi ethnicity faced around twice the risk of death compared with people of White British ethnicity. Under what circumstances is this okay? BAME people are suffering *so* much more as a result of this pandemic than White British people. Helpfully, the BAATN have compiled an online directory of therapists from an array of therapeutic orientations and specialisms, 'all of whom are experienced in working with the distinctive African, Caribbean and South Asian experience.' They also run trainings, events, mentoring programmes, produce podcasts and create book lists, to name just a few aspects of their work. The BAATN are a not-for-profit orgnisation. They run the 'Each one Teach one' Mentoring Programme which 'nurtures Black and Asian psychological therapists through their training' so that they can contribute to mental health care in the UK. If you would like to donate towards this project, you can do so on their website. References Isha McKenzie-Mavinga, The Challenge of Racism in Therapeutic Practice (2nd Edition): Engaging with Oppression in Practice and Supervision, published by Red Globe Press Sample chapter of the book The Black, African and Asian Therapy Network (BAATN) website https://www.baatn.org.uk The Mental Health Foundation report on mental health and Black, Asian and Minority Ethnic (BAME) communities https://www.mentalhealth.org.uk/a-to-z/b/black-asian-and-minority-ethnic-bame-communities Public Health England review 'Disparities in the risk and outcomes of COVID-19' https://cached.offlinehbpl.hbpl.co.uk/NewsAttachments/PGH/disparities_review.pdf I would like to thank Kevin Dawkins from BPDvideo.com who emailed me to tell me about the work of the BAATN which inspired me to write this post. Thank you!

An invalidating environment is one that teaches a child that their thoughts and feelings are wrong, shameful or ‘too much’. Invalidating environments do not give children the skills to name, regulate or cope with their emotions effectively. Marsha Linehan, the psychologist who created Dialectical Behaviour Therapy (DBT), explained that an invalidating environment can play a role in developing BPD. my video on invalidating environments Here are a few examples of invalidating statements: - Stop being so such a cry baby. - You have no reason to be upset. - Other people don’t get so emotional. - Why do you always have to create drama? - You should be over it by now. - Quit your crying. Children who are invalidated tend to try to deal with their emotions alone. The problem is, children don't have the knowledge or skills for dealing with their feelings on their own. The result for some people can be serious emotional dysreglation involving up and down moods, outbursts of emotion and behaviours such as self-harm. Not everyone who experiences an invalidating environment goes on to develop BPD. In her work, Marsha Linehan theorises that some people are born with a more sensitive temperament and this, when combined with an invalidating environment, can lead some people to develop BPD. Can you relate? If so, it might be painful to think about this. Please know that you are not alone in how you feel, there is nothing wrong with you and that emotional regulation can be learnt so that things feel easier for you over time.

Kathy Lisborg is a Licensed Clinical Social Worker (LCSW) in Niagara Falls, New York. Kathy works in the areas of trauma, grief, personality disorders and dual diagnosis. She is currently pursuing her doctorate of social work at the University of Buffalo. The Q&A with Kathy is only the second guest post by a mental health professional that I have published on Talking About BPD. (The first, and very different post, was by researcher and MBT therapist Dan Warrender). What do you like most about working with people with BPD? I enjoy working with people who have complex issues [complex meaning made up of several parts]. I work hard to help people understand the layers of their mental health issues and how they interact and impact them. BPD is often very complex [consisting of lots of parts] and often goes hand in hand with PTSD, depression, generalized anxiety and other mental health issues. I also find that most people with BPD want to learn and want to get better. They often want to understand why they act the way they do when they are overwhelmed. They are invested in treatment. What tips would you give to health and social care professionals working with someone with BPD? I would encourage health and mental health professionals to discuss their caseloads with their supervisor to make sure they address any responses to clients that might interfere with their ability to be empathetic, understanding and, most importantly, patient. It takes patience to work with any client who has a mental health diagnosis. BPD is a complicated and nuanced disorder that requires a lot of work on the part of a client to overcome and that takes time. It is not a linear process. There are 'relapses' and improvements. Sometimes the improvements are smaller and the relapses seem bigger. You have to be able to have a long-term view of things. I would also want to remind any clinicians that this disorder comes from a combination of genetics and environment (which often includes trauma). You have to understand that the behaviors are separate from the thoughts and feelings and that although the behaviors might feel like they are choices, they usually don’t feel that way to the person with BPD. What advice would you give to someone newly diagnosed with BPD? First, take a big breath and don’t google. Or, if you do google, be very particular about your source of information. There is a lot of bad information about BPD out there. People use derogatory language to describe some 'typical behaviors'. I would recommend doing your homework and finding a good therapist who has experience working with people with BPD. I would ask them what their BPD practice consists of --- do they use DBT? Schema therapy? CBT? EMDR? A combination of those? I realize that asking questions of a profession can be difficult for some people. When you have BPD you might already be struggling a great deal within your relationships and add to that a dose of social anxiety and sometimes it can be difficult to ask a professional to explain themselves. It might help to have a list of questions you can read or send them by email and have them answer over the phone or during your first session. One thing I would want is to have a therapist explain what BPD is and how people develop it. I think that will show if they have biases against people with the diagnosis. What would you say to someone with BPD who is feeling hopeless and like things will never get better? I know it’s hard not to feel hopeless. I know this disorder can be so hard to manage and feel like you aren’t making any progress. One thing my clients and I talk about is how BPD lies to them. It lies to you every day. It lies to you that you aren’t worthy. It lies to you that you aren’t lovable. It lies to you and tells you that you aren’t getting better. They are all lies. Try to think of all of the coping skills you’ve learned that don’t fix it, but help a little bit (sometimes). You are making a little bit of progress every day (or week or month). Some days you slide back, but overall you are moving forward. Learning and understanding how this disorder affects you is progress. Learning a new coping skill and practicing it, even when it doesn’t feel like it’s working is progress. Baby steps are progress. I would like to say a big thank you to Kathy for sharing her insights from her professional life supporting people with BPD. I particularly like the point Kathy raises about clinicians needing to address any biases they may have towards people with this diagnosis. I feel this is a key part of removing discrimination and stigma from mental health services. Hear more from Kathy on Twitter > Twitter: @vileloveit644

As I have mentioned on Twitter, I am busy working on a book specifically for people newly diagnosed with BPD. It aims to be a helpful, comforting resource for people who are newly diagnosed complete with coping tips and stories from my life to show you that you're not alone. My book offers an alternative to the stigmatising websites, books and YouTube videos that are all sadly over the internet and book shops. I am absolutely loving writing the book because I get to share my thoughts about why people with BPD deserve so much more care than they often get. It means so much to me to be able to do this. I will keep you updated throughout the writing and editing process, so please check back soon to hear more! Thank you for all of your support and encouragement. Once the book comes out I hope it will help many people know that there is hope and that the stereotypes are not true.

This is one of my most frequently asked questions, so I decided to share my thoughts on it. I think there are as many ways of helping someone as there are individuals because everyone has their own needs and wishes when it comes to support. That being said, I have definitely noticed some general themes of what often works and what usually doesn't, so thought I would outline these below... 1. Ask "how can I support you?" Asking the person with BPD how they want to be helped gives them an opportunity to share their preferences and priorities. Often people with BPD can be embarrassed or ashamed to ask for help and accepting support from others can be hard due to feeling undeserving of it. If someone feels guilty about accepting help, express your desire to help and explain that friendships / family relationships are reciprocal. This means that there will be times when the person being helped will become the helper and can make accepting support easier. 2. don't offer to help more than you can Please don't make promises to help more than you can. Make sure that you know your own limits. Please don't deplete your own energy and time reserves so that you end up resentful and burnt out. If this happens, it can activate so many feelings of shame and guilt in the person with BPD. Please communicate your boundaries clearly, but very gently as people with BPD may struggle with a terrifying fear of abandonment or rejection. It can be very helpful to say something sensitive such as: 'I cannot phone you right now, but please know that I care about you a lot and will speak to you over the next few days'. 3. Silence can be terrifying The worst possible response for me from people I am close to is silence. I find it very scary. Of course, sometimes people cannot reply to messages and phone calls. However, if at all possible, please don't wait several days or weeks to reply if someone with BPD has talked about something emotional or meaningful to them. I find it really helpful to get 'holding' messages such as 'I can't reply properly right now as things are so busy, but I am going to reply to you next week, remember that you are an amazing friend!' If you cannot help anymore, please say so in a gentle way. I would much prefer that to the terror of silence. 4. learn about stigma & its impact Please know that BPD is one of the most stigmatised mental health conditions and with that often comes fear, shame, discrimination and exclusion. Accessing mental health services can be extremely hard. Negative attitudes amongst healthcare professionals still exist. Listen and believe when someone you care about tells you they have been stereotyped or treated disrespectfully. 5. Use validation A validating attitude is one that is willing to listen, curious to understand and non-judgemental. An invalidating attitude is one which criticises, blames or shuts someone down: 'You shouldn't feel like this', 'you are being ridiculous crying over something that didn't actually happen' or 'stop crying over nothing'. Validation means seeing and accepting someone's emotional experience and thoughts, even if you do not think they are true. One example of being validating whilst not agreeing with someone's understanding of a situation is: 'I can see how sad you are, you have been crying all day and lying in bed. I know you think that your friends don't like you, but I can't see the evidence that is the case.' I'm hoping to make a YouTube video soon to add to this post. I hope you found these tips helpful if you care about someone with BPD. If you like Talking About BPD, please consider supporting me on Ko-Fi if you are able to. I keep everything free of charge and don't make any money via my blog & social media, so donations will contribute to my running costs. Thank you to everyone for your encouragement for Talking About BPD.

Here are the answers to some of the questions I am most frequently asked. I hope these videos are helpful or comforting for you. Can I have happy relationships even though I have bpd? What is DBT & how can it help? What books do you recommend about about BPD? What does a BPD 'episode' feel like? Do you take medication? When is it a good time to tell someone I have BPD? Thanks for watching! I try to publish new videos every few weeks, so subscribe to my channel if you want to hear about them.

Dan Warrender is a lecturer in mental health nursing at Robert Gordon University in Aberdeen, Scotland. Dan also continues to practice in the NHS as a mentalization based therapist. His teaching, PhD research and clinical interests are around people diagnosed with ‘borderline personality disorder’. He is currently an executive group member of the Scottish Personality Disorder Network. This is the first ever guest post on the blog written by a mental health professional. I hope you enjoy it. Thank you to Dan for sharing your thoughts, experience and ideas! What do you like most about working with people with BPD? They are people with stories, and often these are stories which have not been heard or understood before. I enjoy working with people and encouraging mentalizing and reflection, so that people can learn about themselves and improve their relationships with others. I also learn something from every person I work with. Exploring people’s minds and lives inevitably leads to reflecting on your own. What tips would you give to health and social care professionals working with someone who has BPD? Try and educate yourself, particularly around the limitations of diagnostic criteria, and the impact of failed attachments, neglect or trauma on symptoms which are often classified as ‘BPD’. People are always much more than the diagnostic label they are given, and need to be understood in the context of their life experiences. Learning and understanding the principles of trauma informed care is also essential, given that a high proportion of people diagnosed with ‘BPD’ have experienced trauma. In addition, some form of clinical supervision or reflective space is necessary, as work can be challenging and anxiety provoking, particularly around risk of harm. A literature review I recently completed found that the things that people value in their care are simple; having access to care, being focused on the person rather than the diagnosis, seeing beyond behaviour and exploring underlying distress, being involved in decisions and being offered hope. There is no reason we can’t achieve this. What advice would you give to someone newly diagnosed with BPD? Remember that you are more than a diagnosis. A diagnosis is a social construction, which may be useful if it provides access to effective treatment, but ultimately it may not explain the reasons you are experiencing the difficulties you are. I’m always careful when I challenge diagnosis, as people’s distress is always real, but it just does not fit neatly into a checklist. Diagnosis is more of a ‘what’s wrong’ than a ‘what happened’, and the best way of understanding your difficulties may be through a formulation, a kind of life story rather than a label. The reason I always use inverted commas around ‘BPD’ is to highlight the considerable critique of the diagnosis, as it is critiqued as invalid, ignorant of people’s life experience and inherently stigmatising. What do you think is the biggest misconception about BPD amongst professionals? That the distress experienced by people diagnosed with ‘BPD’ is “just behaviour”. Hearing this is unquestionably my biggest frustration. All behaviour is about something, driven by mental states such as thoughts and feelings, and therefore is full of meaning. To say anything is “just behaviour” is a failure in empathy and mentalizing. What advice would you give for the loved ones of someone with BPD? That often the difficulties in interpersonal relationships are down to misunderstandings, and the key is to try to understand the misunderstanding. Sometimes people don’t make sense to us, and we need to reflect and mentalize, considering what another person may be thinking and feeling, while being mindful of how we may be impacting on them. There are so many things unsaid in relationships, and I would encourage honest but sensitive conversations about what everyone is going through. The things we don’t say, others may never know. How do you feel when you hear stereotypes about people with BPD, such as the myth that people with this condition are attention-seeking or manipulative? It frustrates me that not only do some professionals misunderstand and dismiss the distress of people diagnosed with ‘BPD’, but that they actually make their own jobs more difficult. We often wonder why some people in care do not make progress, but this can be because the professionals lack hope, and outcomes become a self-fulfilling prophecy. Because some people hold these attitudes, they don’t put effort and commitment into working with people, and as a result people don’t improve. What would you say to someone with BPD who is feeling hopeless and like things will never get better? It may be very hard, and it may take time, but you can get better. I’m always careful not to invalidate the very real feeling of hopelessness, and try and hang onto hope for people if they can’t at that moment. Evidence tells us that generally people improve over time, however I’m aware every minute can feel like an eternity if you are struggling inside your own skin. There is no linear path to recovery, and it’s a process that’s unique to every individual. People do get better, and so can you. Thank you again to Dan for this thought-provoking post. I especially liked reading Dan's point that all behaviour is driven by mental states. I think everyone who knows someone with mental health problem could benefit from remembering this idea as it can help create compassion and understanding, rather than frustration or confusion. Wishing Dan all the best with his PhD research! Check out these links below to find out more about Dan's work, his research and to read his blog > Twitter: @dan_warrender Blog: https://danwarrendersmentalhealthblogma.wordpress.com/blog/ Staff Profile: https://www3.rgu.ac.uk/dmstaff/warrender-dan Research Gate Profile: https://www.researchgate.net/profile/Dan_Warrender2

I'm keeping my blog post fairly short today as I am busy working on a book based on my blog! When it comes out I hope you will find it comforting and helpful for managing your BPD (more updates about my book coming soon!). What is emotional reasoning? Emotional reasoning is a term created by Aron Beck, one of the founders of cognitive therapy and cognitive behaviour therapy, back in the 1970s. Beck identified emotional reasoning as a cognitive distortion, also commonly referred to as a 'thinking error' or a 'thinking trap'. Emotional reasoning is when someone uses their emotions as proof, rather than using facts. When someone is using emotional reasoning, they believe something is true their emotions convince them that something is true rather than factual evidence. During a period of emotional reasoning, someone could forget to look for evidence, choose not to look at evidence, ignore the facts or decide that the facts are wrong. An Example of Emotional reasoning One common example of emotional reasoning is feeling anxious and thinking that your house will be burgled whilst you are out shopping. Your thoughts tell you that you maybe you didn't lock the door, perhaps you left the kitchen window open and maybe your front door is not strong enough to resist being kicked in. Your anxiety is so strong that you feel *convinced* that right now someone is burgling your house. However, the facts of the matter are that you have never once forgotten to lock the door, you checked the windows twice before you left and your partner even reassures you that they saw you check twice. In spite of this evidence that your house is safe, your anxiety makes you desperate to rush home to check that your house is safe. You are now faced with a choice to either listen to the anxiety and run home or listen to the facts and enjoy your time shopping. Why is emotional reasoning so powerful? Emotional reasoning is so powerful because of thoughts and emotions can accelerate one another. When I have the thought 'my house is going to be burgled', I feel anxiety. The more anxiety I feel, the more likely I am to have another anxious thought and then the more anxiety I feel- and so it goes on. What can help me manage emotional reasoning? One of the best ways to manage emotional reasoning is to step back from the thoughts. Some of the most common strategies for learning to step back from thoughts are mindfulness techniques. These can involve imagining thoughts as clouds in the sky passing by, leaving floating past on a stream or trains passing through a station and you not boarding the carriages. When individuals try to push away thoughts or control them, they tend to come back stronger. If you tell yourself to 'stop thinking about _______', have you noticed how you think about it more? Another technique that can be very useful for managing emotional reasoning is the DBT skill called 'check the facts'. It's one of favourite DBT skills and, in essence, it involves noticing a thought and then checking the facts to see if it's true or not. Take a look at this worksheet for 'check the facts' which is taken from DBT Skills Training Handouts and Worksheets by Marsha M. Linehan. Hope you find this post useful and if you are interested in hearing updates about my forthcoming book, check the blog every now and again or follow me on Twitter or Instagram.